Author + information
- Received April 18, 2013
- Accepted April 23, 2013
- Published online October 8, 2013.
- Ting-Wei Lin, MD, MSc∗,
- Meng-Da Tsai, MD∗,
- Jun-Neng Roan, MD∗,†,
- Hung-Wen Tsai, MD†,‡,
- Jing-Jou Yan, MD‡ and
- Chwan-Yau Luo, MD, MSc∗,§
- ∗Division of Cardiovascular Surgery, Department of Surgery, National Cheng-Kung University Hospital, Tainan, Taiwan
- †Institute of Clinical Medicine, National Cheng-Kung University Hospital, Tainan, Taiwan
- ‡Department of Pathology, National Cheng-Kung University Hospital, Tainan, Taiwan
- §Cardiovascular Research Center, National Cheng-Kung University Hospital, Tainan, Taiwan
A 64-year-old man with no other medical history underwent a pericardiotomy for pericardial effusion with tamponade. The pericardium showed chronic inflammation but no malignancy; the effusion cytology was unremarkable. The only abnormal finding was a cancer antigen 125 (CA-125) level of 95.5 U/ml. Five months later, a pericardial cystic lesion developed that compressed the right ventricle and atrium (A and B). His CA-125 level rose to 207.5 U/ml, and the cystic wall showed hypermetabolic uptake on a positron emission tomography/computed tomography scan (C). Intraoperatively, the lesion showed a thickened and adhered pericardial wall containing dark-brown effusion (D); it was completely excised, and a bilateral partial pericardiectomy was conducted. Pathological examination of the excised cystic pericardium revealed caseating granulomatous inflammation with bacilli positive for acid-fast stain (E and F), and a tuberculosis polymerase chain reaction was positive for tuberculous pericarditis. A 6-month antituberculosis regimen (rifampicin, isoniazid, pyrazinamide, ethambutol) for extra-pulmonary tuberculosis was prescribed.
- Received April 18, 2013.
- Accepted April 23, 2013.
- American College of Cardiology Foundation