[A case of cardiovascular Behçet's disease detected as multiple nodular shadows on chest X-ray]

A case of cardiovascular Behçet's disease is reported. A 30-year-old man was admitted to our hospital with a high fever. Multiple nodular shadows were revealed on chest X-ray. Echocardiography revealed a mural thrombus in the right ventricle. A diagnosis of multiple pulmonary septic embolisms was made, and antibiotics were administered. The mural thrombus soon resolved, but later recurred in the same location. On the 90th day after admission. The mural thrombus was surgically removed. Histologically, the thrombus consisted of numerous neutrophils and fibrin. Examination of the endocardium attached to the thrombus revealed nonspecific inflammation, with fibrotic change and necrosing granulation present. A diagnosis of cardiovascular Behçet's disease was made based on the following findings: oral ulcerations, acneiform nodules, thrombophlebitis, bilateral uveitis, and positive HLA-B51. After treatment with steroid hormones and cyclosporine, the thrombus resolved completely, and inflammatory signs diminished. Though various clinical and pathological characteristics of cardiovascular Behçet's disease have been reported, it is rare for a mural thrombus to produce multiple pulmonary septic embolisms.