Intravascular Lipiodol Presenting as an Atrial Mass

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Presentation transcript:

Intravascular Lipiodol Presenting as an Atrial Mass Ruud S. Kootte, MD, Joost D.E. Haeck, MD, PhD, Krijn P. van Lienden, MD, Wim J.P. van Boven, MD, PhD, Allard C. van der Wal, MD, PhD, Hans H. de Boer, MD, PhD The Annals of Thoracic Surgery Volume 103, Issue 3, Pages e231-e233 (March 2017) DOI: 10.1016/j.athoracsur.2016.08.025 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Echocardiographic findings. Transthoracic echocardiographic images of the right-sided mass. (A) Four-chamber view demonstrating a mass, ranging from the inferior vena cava (IVC) into the right atrium (RA) and the right ventricle (RV). (B) Parasternal short-axis image at the level of left ventricle (LV) showing a mass of 23 × 25 mm in RV. The Annals of Thoracic Surgery 2017 103, e231-e233DOI: (10.1016/j.athoracsur.2016.08.025) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Macroscopic findings of the mass in the right atrium. It ranges from the inferior vena cava (IVC) to the right atrium and consists of thrombus admixed with strands of pale yellowish material. The Annals of Thoracic Surgery 2017 103, e231-e233DOI: (10.1016/j.athoracsur.2016.08.025) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Histologic findings. (A) Low-power view of the thrombus mass admixed with distinct garland-like optically empty spaces (hematoxylin and eosin; magnification ×2.5). (B) Detail of the laminated part of the mass shows a distinct lining with macrophages and multinucleated giant cells (hematoxylin and eosin; ×20). (C) Immunopositive staining of macrophages and giant cells with CD68 antibody (magnification, ×10). (D) Oil Red O staining reveals that the optically empty spaces contain thin band of lipid-rich foreign material (magnification, ×10). The Annals of Thoracic Surgery 2017 103, e231-e233DOI: (10.1016/j.athoracsur.2016.08.025) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions