"Triple Trouble" in A Case of Mass Lesion.

Figures

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  Figure 1. CXR and ultrasound images. A: CXR shows left upper zone homogenous opacity with left CP angle blunting and left diaphragm elevation, nodular opacities are seen in right middle and lower zone, cardiomegaly with prominent right cardiac borders and right fissure thickening; B: A mixed echoic mass measuring 4 cm×6 cm in RV in flow just below the tricuspid valve without causing significant turbulence across tricuspid valve. CXR: chest radiograph.

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  Figure 2. CT images. A: Axial cut showing a well-defined heterogeneously enhancing lesion with irregular margins noted in left upper lobe and bilateral multiple nodules and minimal pleural effusion on left side; B: Sagittal cut showing a well-defined heterogeneously enhancing lesion with irregular margins noted in left upper lobe; C: Axial cut showing a heterogeneous opacity in right ventricle of heart, exophytic and completely intraluminal with moderate pericardial effusion; D: Sagittal cut showing a heterogeneous opacity in right ventricle of heart, exophytic and completely intraluminal and a small heterogeneous opacity along lateral left ventricular wall. CT: computed tomography.

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  Figure 3. Pathological pictures. A: A tumor arranged in glands and acini which have moderate degree of nuclear pleomorphism, hyperchromatic nuclei with scanty cytoplasm and vacuolations; B: HPE showing tissue with alveoli and pneumocyte hyperplasia with interstium showing epithelioid granulomas with caseous necrosis.