J Korean Soc Radiol.  2015 Oct;73(4):269-273. 10.3348/jksr.2015.73.4.269.

Tumor-Mimicking Large Vegetation Attached to the Tricuspid Valve without Predisposing Factors: A Case Report on CT and Echocardiographic Findings

• Bae JM
• Choe YH
• Hwang HW
• Kim JS
• Kim WS
• Peck KR
• Park SJ

• KMID: 2068719
• DOI: http://doi.org/10.3348/jksr.2015.73.4.269

Abstract

We report the CT and echocardiographic findings of a tumor-mimicking large vegetation attached to the tricuspid valve (TV) of a 45-year-old man without predisposing factors. Echocardiography revealed a mobile homogeneous echogenic mass attached to the TV. Cardiac CT showed a 4.5 x 2.3 cm irregular low-density mass with scant enhancement in the right ventricle. Based on clinical findings of fever, positive blood culture results for Streptococcus viridans, and pathologic confirmation of the lesion, a diagnosis of infective endocarditis and vegetation was made.

MeSH Terms

Causality*
Diagnosis
Echocardiography*
Endocarditis
Fever
Heart Ventricles
Humans
Middle Aged
Tricuspid Valve*
Viridans Streptococci

Figure

• 

  Fig. 1 A 45-year-old man with a mass in the right ventricle. A. Transthoracic echocardiogram revealing a 4.5 × 2.3 cm highly mobile homogeneous echogenic mass (arrow) attached to the tricuspid valve (arrowhead). B, C. Four-chamber (B) and short-axial (C) CT reformatted images showing a 4 cm irregular low-density mass with an attenuation value of 75 HU (arrows in B and C). The mass is seen attached to the tricuspid valve on 4-chamber view (arrowhead in B). D. Virtual endoscopic CT reconstructed image demonstrating attachment of the mass to the tricuspid valve (arrow). E. Photomicrograph revealing multiple bacterial colonies (arrows) intermingled with fibrinopurulent inflammatory exudate (arrowheads) (hematoxylin and eosin stain, magnification × 200). AV = aortic valve, HU = Hounsfield units, M = mass, RA = right atrium, RV = right ventricle

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