(A) (B)
Figure 2 : Echocardiography showed moderate pericardial effusion without signs of tamponade (A and B)
Due to the concerns of malignancy and risk for tumor dissemination, high-complexity fluoroscopy-guided pericardiocentesis was performed for symptomatic relief and cytological examination. The procedure was successful without complications. The core biopsy tissue contained a neoplasm composed of variably sized lobules/nodules of cells separated by broad fibrous bands. The cellular component is composed of a mixture of abundant small round lymphocytes and variable numbers of epithelial cells with ill-defined cell borders. The epithelial cells have large and round vesicular nuclei with occasional small pinpoint nucleoli. These were highlighted by immunohistochemistry for CK5 and p40. No necrosis or cytologic features of carcinoma were identified. The combined morphology and immunohistochemical test results are indicative of thymoma, subtype WHO B2.