Key result
Surgical biopsy secures definitive diagnosis and favorable management in unexplained massive pericardial effusion.
Why the study?
Intrapericardial lymphangioma is a rare benign tumor that may cause unexplained pericardial effusion and is difficult to diagnose with noninvasive imaging alone.
Case Report (n=1)
Tissue biopsy should be considered early in patients with unexplained pericardial effusion and associated masses when noninvasive imaging is inconclusive.
May support biopsy consideration in imaging-inconclusive pericardial effusions; leaves open need for prospective validation.
BACKGROUND: Intrapericardial lymphangioma is a rare benign lymphatic tumor that may present with nonspecific findings and unexplained pericardial effusion, posing a diagnostic challenge. CASE SUMMARY: A 33-year-old woman presented with dyspnea and a large pericardial effusion without tamponade. Multimodality imaging revealed multiloculated pericardial and mediastinal lesions, but diagnosis remained uncertain. Because of inconclusive findings, surgical biopsy was performed. Histopathology and immunohistochemistry (ETS-related gene, CD31, and D2-40) confirmed intrapericardial lymphangioma. The patient underwent partial pericardiectomy with a favorable outcome. DISCUSSION: Noninvasive modalities may be insufficient to determine the etiology of pericardial effusion with associated masses. Tissue diagnosis is often required. TAKE-HOME MESSAGE: Early tissue diagnosis should be considered in unexplained pericardial effusion when imaging is inconclusive.
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Kim et al. (2026) conducted a case report in Intrapericardial lymphangioma with unexplained massive pericardial effusion (n=1). Surgical biopsy and partial pericardiectomy was evaluated. Surgical biopsy confirmed intrapericardial lymphangioma in a patient with unexplained massive pericardial effusion when noninvasive imaging was inconclusive, leading to a favorable outcome.
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