Clinical Presentation
A 50-year-old woman with dyspnea on exertion.
Further Work-up
Imaging Findings
(A) Chest radiograph demonstrates a globular enlarged cardiac silhouette (arrows). Linear atelectasis is seen in the left lung. (B) Contrast-enhanced computed tomography (CT) through the right ventricle (soft-tissue window) shows a large pericardial effusion. A large mass is invading the right ventricle (arrow). (C) Contrast-enhanced CT through the caudal margin of the pericardium (soft-tissue window) shows an extensive amount of pericardial fluid. Although the fluid is predominantly of low density, a curvilinear area of high density is seen anterior to the inferior vena cava (IVC, arrow). (D) Contrast-enhanced CT (soft-tissue window) through the abdomen demonstrates a large mass occupying most of the right abdomen (long arrow). There is a resultant mass effect on the ascending colon and IVC. The density is heterogeneous, but there are extensive areas of very low density.
Differential Diagnosis

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