Case of the Month May 2014, page 2

Answer: The CXR demonstrates a moderately enlarged cardiac silhouette and clear lung fields.  Any of the above choices, or a combination thereof, can present in this manner.

Patient was found to have a hemodynamically significant pericardial effusion on echocardiography and underwent pericardiocentesis, which yielded 900cc of dark blood.  A contrast-enhanced chest CT the following morning showed the following:

For full-size images, please click on: Ardestani 2 , Ardestani 3 and Ardestani 4

For full-sized images, please click: Ardestani 5 and Ardestani 6 .

How can the differential diagnosis be narrowed?

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