Percutaneous intravenous catheter forceps biopsy in right atrial mass: two case reports and literature review

Fig. 1. CMR shows the right atrium soft tissue mass closed to the tricuspid orifice (a). PET/CT scan suggests intensive tracer uptake of the right atrial mass, pericardium, lung and mediastinal lymph nodes (b, c)

Fig. 2. CT imaging displayed right atrium mass (a) and suspected metastases in liver (b). Scan enhancement CT scan show abnormal signals in the right atrium, pericardium (c), and liver (d) in 2 months. After 5 cycles of comprehensive immune anti-tumor therapy, significant reduction is detected in the right atrial intimal sarcoma (e) and liver mass (f) dimension

Fig. 3. The pathology of the first biopsy via femoral vein shows a large amount of cellulose and blood cells, diagnosed as thrombus (a hematoxylin and eosin, 40 × 10). The pathology of the secondary biopsy through the right internal jugular vein reveals a spindle cell tumor, some areas are rich in spindle cells, with moderate atypia and focal necrosis, and the histology is consistent with intimal sarcoma (b hematoxylin and eosin, 40 × 10). Immunohistochemistry-positive neoplastic cells for PRAME (c 40 × 10)

Fig. 4. CMR confirmed left atrial mass invaded right atrium (a, b) and PET-CT scan revealed high FDG uptake in atrum and mediastinal lymph nodes (c)

Fig. 5. The histopathological section shows diffuse growth of large lymphocytes with a small amount of apoptotic necrosis (a hematoxylin and eosin, 40 × 10). Immunohistochemistry-positive neoplastic lymphoid cells for CD20 (b 40 × 10), CD5 (c × 400) and Bcl2 (d 40 × 10)