Related Experiment Videos
Localized pericarditis with calcifications mimicking a pericardial tumor
1Cardiology, Tobu Chiiki Hospital, Tokyo Metropolitan Health and Medical Treatment Cooperation.
Insights
A calcified pericardial thickening mimicking a tumor was found to be a pus-filled abscess caused by Propionibacterium acnes. This rare cardiac mass presentation highlights the importance of considering infectious etiologies.
Area of Science:
- Cardiology
- Infectious Diseases
- Pathology
Background:
- Pericardial masses can present as calcified lesions on radiography, potentially mimicking tumors.
- Right ventricular compression by cardiac masses can lead to significant symptoms like palpitations.
Observation:
- A 62-year-old man presented with palpitations due to a calcified mass compressing his right ventricle.
- Imaging revealed a mass with unclear vascular supply, and cardiac catheterization showed no specific pressure patterns.
Findings:
- Surgical exploration identified the mass as a focal calcified pericardial thickening containing pus.
- Microbiologic analysis confirmed the presence of Propionibacterium acnes within the purulent material.
Implications:
- This case underscores that calcified pericardial thickening can represent an infectious abscess, not a neoplastic tumor.
- Prompt diagnosis and appropriate antimicrobial therapy are crucial for managing such rare presentations of pericardial disease.
Abstract:
A 62-year-old man was admitted with increasing palpitations. Radiography of the chest demonstrated a calcified mass. Magnetic resonance imaging revealed compression of the right ventricle by a tumor. At the time of cardiac catheterization, the coronary arteries were found not to supply blood flow of the mass, and no dip-and-plateau pattern was seen in the right ventricular pressure measurements. At the time of surgery, the mass was found to be a focal calcified thickening of the pericardium containing only pus. The thickening resembled an oval pericardial tumor. Microbiologic examination of the pus revealed Propionibacterium acnes.