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.