Korean J Med.  2009 Apr;76(Suppl 1):S81-S86.

A case of malignant pericardial mesothelioma misdiagnosed as tuberculosis pericarditis

• Cho I
• Chun EJ
• Jeon KH
• Lim WH
• Kim KH
• Kang SH
• Chang HJ

Abstract

Primary pericardial mesothelioma is an extremely rare neoplasm with a bleak prognosis. It is often misdiagnosed as constrictive pericarditis initially, especially as tuberculosis pericarditis in Korea due to the high incidence of active tuberculosis. A targeted pericardial biopsy and noninvasive imaging modalities, such as delayed phase contrast chest computed tomography (CT) images and magnetic resonance imaging (MRI), can play an important role in the differential diagnosis of pericardial disease. We present the case of a 37-year-old man with a 3-week history of exertional dyspnea. A large pericardial effusion with pericardial thickening was noted, but its etiology was not revealed after conventional diagnostic procedures, including a closed pericardial biopsy. Empirical antituberculosis treatment was started, but the dyspnea recurred 5 months later. A malignant pericardial mesothelioma was diagnosed through a pericardiectomy and biopsy under direct visualization

Keyword

Mesothelioma; Pericardial effusion; Tuberculous pericarditis

MeSH Terms

Adult
Biopsy
Diagnosis, Differential
Dyspnea
Humans
Incidence
Korea
Magnetic Resonance Imaging
Mesothelioma
Pericardial Effusion
Pericardiectomy
Pericarditis
Pericarditis, Constrictive
Pericarditis, Tuberculous
Prognosis
Thorax
Tuberculosis