Fig. 21.1
Frontal radiograph of the chest (left) with a coronal image from a PET CT (right) in a 1-year-old patient after heart transplantation. The chest x-ray shows a large mass along the left heart border (arrow), which corresponds to a metabolically active focus on PET CT. Tissue sampling confirmed lymphoma
Bloodborne metastases, propagated to the heart through the coronary arteries
Direct extension to cardiac structures
Posttransplant patients at risk for lymphoma or lymphoproliferative disease (Fig. 21.2)
Fig. 21.2
Axial images from a contrast-enhanced CT scan in a 15-year-old patient with Ewing’s sarcoma of the hip show multiple metastases to the chest (Met) with invasion into the right heart border and a malignant pericardial effusion (Eff), confirmed on pericardiocentesis
21.5 Clinical Issues
21.5.1 Presentation
Patient with cardiac metastases typically present with arrhythmia or fatigue from large pericardial effusion, which decreases myocardial function (Figs. 21.3 and 21.4).
