Pericardial effusion

Case contributed by A.Prof Frank Gaillard




Modality: X-ray

Enlarged cardiac silhouette with globular shape, without evidence of pulmonary venous congestion. Lungs and pleural spaces are clear. 


Modality: CT

Pericardial effusion is evident (increased fluid-density around the heart) and this is the cause of the enlarged cardiac silhouette on chest x-ray. Numerous axillary and mediastinal lymph nodes.

Oreo cookie sign

Modality: Annotated image

Pericardial fluid (yellow *) outlined by epicardial fat (blue arrows) and pericardial fat (orange arrows), giving a three layered appearance, known as an Oreo cookie sign. 

Case Discussion

Pericardial effusion in a woman with chronic lymphocytic leukaemia (biopsy-proven). Chest x-rays demonstrate a globular shaped heart, without evidence of pulmonary venous congestion.

CT confirms the presence of a pericardial effusion as well as numerous axillary and mediastinal lymph nodes.

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Case Information

rID: 8694
Case created: 23rd Feb 2010
Last edited: 8th May 2017
System: Chest
Inclusion in quiz mode: Included

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