Large Mediastinal Mass in Pregnancy: Utility of Echocardiography and Cardiac MRI

Abstract

A 29-year-old woman at the 27th week of gestation was admitted to the hospital for dyspnea, chest pain radiating to the left shoulder and fatigue. An echocardiogram showed the presence of a pericardial effusion and an inhomogeneously echogenic mass, before the right ventricle, in the mediastinum, that modified the geometry of the right ventricle without impairing its filling. A cardiac MRI, subsequently performed, better defined the mass dimension and its contiguity relationship; moreover, it confirmed the suspicion of a lymphoproliferative disease. A mediastinal biopsy showed an infiltrating non-Hodgkins lymphoma at B big cells. After waiting until the 30th week of gestation, we proceeded to caesarean delivery, excellently succeeded, and contemporaneously to mass excision. Echocardiography was able to identify the presence of the mediastinal mass and to monitor its consequences on cardiac haemodynamic. Cardiac magnetic resonance was performed safely after the third trimester without producing apparent problems in the newborn. It helped in giving information on the mass dimension and its contiguity relationship but didnt characterize the mass.




J Med Cases. 2011;2(1):13-14
doi: https://doi.org/10.4021/jmc92w