• Journal of Chest Surgery
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• v.38 no.5 s.250
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• pp.392-395
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• 2005

Primary pericardial mesothelioma is extremely rare and the incidence is low among the mesotheliomas that originate from other parts of the body. The prognosis of the tumor is unfavorable due to its late presentation, difficulties in early diagnosis and complete resection, and the limited treatment options. Herein, we report a case of pericardial mesothelioma. The patient is a 55-year-old woman who presented with chronic cough and dyspnea. During the examination, pericardial effusion was found and pericardial window formation was followed. She visited our hospital because of persistent dyspnea, with right shoulder and chest pain. Four discrete masses were discovered in the chest CT. CT guided-fine needle aspiration biopsy was negative for malignancy. Right exploratory thoracotomy and partial resection of 3${\times}$3 cm mass abutting pericardium was performed and was histologically diagnosed as malignant mesothelioma, biphasic type. Pericardial mesothelioma is rare, but it should be remembered as an important differential diagnosis in patients with persistent pericardial effusion and symptoms of dyspnea and constrictive pericarditis.

• Journal of Chest Surgery
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• v.30 no.7
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• pp.693-700
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• 1997

To assess the effectiveness of subxipoid pericardial drainage for the treatment of pericardial effusion, we reviewed 80 cases of subxiphoid pericardial drainage between January 1986 and December 1995. There were 39 males and 41 females with ages ranging from 20 to 80 years. The diagnosis of pericardial effusion was made by echocardiography. The procedure was carried out under general anesthesia in 50(62.5%) and under local anesthesia in 30 patients(37.5%). Among the 33 p tients with malignant pericardial effusion, cytology was positive .in 14 of 31(45%), and pericardial biopsy showed malignancy in 7 of 29 patients(24%). Among the 27 patients with tuberculous pericardial effusion, the diagnosis was confirmed by histology of pericardial biopsy in 12 patient or bacteriologic culture in 1 patient. The operative mortality was 17.5% (14180 patients) and all the mortality occurred in the malignant group. There were no operation-related mortality Sixty six patients were followed from 9 days to 5 years; mean follow-up was 452 days. Recurrent pericardial effusions, necessitating further surgical intervention, occurred in 6 (7.5%) patients. Constrictive pericarditis developed later in 4 patients(5%) and two of them had undergone complete pericardiectomy. In summary, subxiphoid pericardial drainage allowed safe and efficient drainage of pericardial effusions with sampling for cytology and pericardial biopsy, and had an acceptable morbidity and mortality.

• Clinical and Experimental Pediatrics
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• v.49 no.6
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• pp.686-690
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• 2006

Cardiac tamponade with pleural and pericardial effusion is a rare but life-threatening complication of umbilical venous catheterization in the newborn. It requires a timely diagnosis and urgent treatment, such as pericardiocentesis, to save lives of affected patients. Recently, we experienced a 7 day-old, very low birth weight infant, who developed a cardiac tamponade with pleural and pericardial effusions complicated by umbilical venous catheterization. The patient was successfully treated with pleural and pericardial drainages. Here, we report this case with a review of literature, since there has been no such previous case reported in Korea.

• Journal of Veterinary Clinics
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• v.40 no.4
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• pp.308-313
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• 2023

A 1-year-old castrated male Korean Shorthair cat presented with dyspnea, anorexia, lethargy, and seizures. Physical examination revealed salivation, right forelimb hemiparesis, and rapid breathing. No abnormalities were detected on auscultation. Laboratory findings revealed increased levels of bilirubin, aspartate aminotransferase (AST), globulin, glucose, and a decreased albumin-to-globulin (A:G) ratio. Both N-terminal pro-B-type natriuretic peptide (NT-proBNP) and feline serum amyloid A (fSAA) levels were significantly elevated. Thoracic radiography revealed mild cardiomegaly and diffuse increased interstitial infiltration with soft tissue opacity in the periphery of the right caudal pleural space. Echocardiography and lung ultrasonography were performed to investigate the cause of mild cardiomegaly and soft tissue opacity in the pleural space. Echocardiography revealed a mild amount of echogenic pericardial effusion, and lung ultrasonography showed an echogenic soft tissue mass with no blood signal in the right caudal pleural space, suggestive of a granulomatous lesion. After obtaining 5 mL of pericardial fluid through pericardiocentesis, cytology of the pericardial effusion sample revealed marked neutrophils and macrophages with no bacteria. IDEXX feline infectious peritonitis (FIP) virus real-time reverse transcriptase polymerase chain reaction (RT-PCR) confirmed the presence of the FIP virus biotype in the sample. This case presents a rarely reported atypical mixed form of FIP in a cat diagnosed ante-mortem using pericardial effusion analysis. In this case, ultrasound examination played a crucial role in the definitive diagnosis of FIP by PCR biotyping through pericardiocentesis. Ultrasonography can be highly beneficial in guiding the diagnosis and evaluation of cats with suspected FIP.

• Journal of Veterinary Clinics
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• v.41 no.3
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• pp.170-177
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• 2024

An adult male dog was presented for hemorrhagic pericardial effusion. Echocardiography and computed tomography revealed nodule-like lesions on the pericardium. Cytology of pericardial effusion and excisional pericardial lesions indicated neoplastic effusion. Histopathology indicated an inflamed neoplasm with a primary differential diagnosis of hemangiosarcoma and malignant mesothelioma (MM). Immunohistochemistry showed that atypical cells were positive for cytokeratin and vimentin, but negative for CD31, strongly favoring pericardial MM. Postoperative NT-proBNP level remained increased, which led to the administration of epirubicin to minimize potential cardiotoxicity. During the 4 cycles of epirubicin treatment, a total cumulative dose of 108 mg/m² was administrated and no effusion recurrence was observed. After a month post-completion of chemotherapy, however, pleural effusion was detected with cardiac masses. The owner requested no further diagnostic investigations and chemotherapy. Due to deteriorating conditions, the dog died 132 days after the first presentation. Our case is the first notable attempt to treat canine malignant mesothelioma with epirubicin, providing the clinicopathologic, diagnostic routine, and clinical course of the affected dog.

• Journal of the korean veterinary medical association
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• v.38 no.9
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• pp.824-829
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• 2002

A 4-year-old, female pomeranian was admitted to Veterinary Medical Teaching Hospital of Seoul National University for evaluating cough and acute abdominal distension. Idiopathic pericardial effusion was diagnosed by radiography, echocardiography and analy

• Journal of Veterinary Clinics
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• v.32 no.5
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• pp.433-435
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• 2015

A 12-year-old spayed female, Golden Retriever presented with dyspnea and lethargy of 3 months duration. Pericardial effusion and cardiac mass were identified on echocardiography. Pericardiectomy and mass resection were performed for treatment of pericardial effusion and histopathological analysis was conducted for the definitive diagnosis. The mass was diagnosed as hematoma with mainly erythrocyte, fibrin and many of neutrophils based on microscopic description. Severe purulent pericarditis thickened by inflammatory cells and reactive fibrous tissue were identified, but not diagnosed as neoplasm. This is the first case report in veterinary literature of a dog with pericardial effusion caused by cardiac hematoma.

• Journal of Veterinary Clinics
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• v.27 no.6
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• pp.729-734
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• 2010

An 11-year old, intact female Poodle (weighing 2.3 kg) was referred with signs of consistent coughing, dyspnea, poor exercise tolerance, and anorexia. Diagnostic imaging and laboratory studies revealed idiopathic hemorrhagic pericardial effusion complicated with ISACHC Ib stage of chronic mitral valvular degeneration. Percutaneous transcatheter pericardiotomy (PTP) was performed at the right precordium using alligator forceps with fluoroscopic guidance. Immediately after PTP, electrocardiogram and echocardiogram showed dramatic improvement of cardiac performance. Patient was released with the prescription of furosemide (1 mg/kg, bid, PO), enalapril (0.5 mg/kg, bid, PO), cephradine (20 mg/kg, bid, PO) for mild mitral regurgitation and post-management of infection. Diagnostic studies performed at 2 weeks after PTP revealed no further accumulation of pericardial effusion and improvement of clinical signs. The dog is currently medicated with enalapril and monitored regularly.

• The Korean Journal of Nuclear Medicine
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• v.35 no.4
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• pp.291-292
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• 2001

We report a case of malignant pericardial effusion originated from adenocarcinoma of the lung incidentally diagnosed by bone scintigraphy, prior to echocardiographic detection. A 76 year-old man with adenocarcinoma of the lung underwent Tc-99m MDP bone scintigraphy to evaluate skeletal metastasis. Anterior images of the chest of the bone scintigraphy unexpectedly showed diffuse increased activity in the region of the heart surrounded by an oval-shaped band of increased activity corresponding to the periphery of the cardiac silhouette (Fig. 1). There was no evidence of bony metastasis. Pericardial effusion was confirmed by echocardiography (Fig. 2) and malignant cells were revealed by subsequent microscopic examination of the pericardial fluid. Bone scintigraphy using Tc-99m phosphate compounds is commonly used to detect bony metastasis in cancer patients. Tc-99m phosphate compounds occasionally accumulate in extra-osseous sites, including $pleural^{1,2)},\;pericardial^{3,4)},\;and\;ascitic\;fluids^{5,6)}$. It has been reported that their accumulation in serous effusions should strongly suggest $malignancy^{1-6)}$. The exact mechanism for accumulation of Tc-99m phosphate compounds in serous effusions is unclear. Several investigators have proposed that the radiopharmaceuticals exuded directly from peripheral vessels to the serous cavity due to increased vascularity and vascular permeability, and bleeding by disruption of blood vessels due to cancerous $infiltration^{5,6)}$.

• Journal of Veterinary Clinics
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• v.41 no.2
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• pp.106-111
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• 2024

A 4-year-old neutered female domestic shorthair cat weighing 5.1 kg was referred to Jeju National University Hospital with acute onset respiratory distress, weakness, and anorexia. The patient had a history of stressful antecedent events that involved bullying by a newly introduced cat. Thoracic radiography and echocardiography revealed a stage C hypertrophic cardiomyopathy phenotype based on the American College of Veterinary Internal Medicine classification system with pulmonary edema, pleural effusion, and pericardial effusion at the same time. The patient was treated with furosemide, pimobendan, and rivaroxaban. Pericardiocentesis was performed because pericardial effusion was identified. Reevaluation after 30 days revealed a normal respiratory rate on physical examination, normal cardiac shape on thoracic radiographs, and normal cardiac measurements on echocardiography. The patient was tentatively diagnosed with transient myocardial thickening (TMT) and all medications were discontinued. Six months after the initial hospitalization, the cat continued to do well without any clinical signs or left ventricular wall thickening. This case is the first report describing feline TMT in Korea. Moreover, it involves a rare case in which pulmonary edema, pleural effusion, and pericardial effusion, which induce cardiac tamponade, occurred simultaneously due to TMT-related congestive heart failure.