5),8) Chest X-ray is not usually helpful, showing non-specific signs such as pleural effusion and/or cardiomegaly. Transthoracic echocardiography (TTE) is currently the most widely used diagnostic procedure for the detection of cardiac tumors. Transesophageal echocardiography (TEE) is reported to provide superior diagnostic imaging than TTE, also useful at surgical resection and transvenous biopsy.2) CT and MRI have better contrast resolution

than echocardiography and can give Inhibitors,research,lifescience,medical a specific diagnosis for a number of tumors.3) Gallium-67 and Technesium-99m (Tc-99m) Sestamibi scan also has been reported to be valid myocardial perfusion Inhibitors,research,lifescience,medical tracers for detecting PCL and during

the follow-up.1) CT scan and MRI are the mainly used imaging techniques to detect cardiac tumors. But histologic and immunohistochemical examination of the involved tissue, as well as cytologic examination with cytogenetic studies of pericardial effusion, is always required to confirm diagnosis.4) Although PCL was a near fatal disease in the past, recent Vorinostat IC50 advances in imaging diagnosis and chemotherapy have dramatically improved survival.3) Inhibitors,research,lifescience,medical So, non-invasive and early diagnosis is fundamental to allow prompt initiation of aggressive treatment; however, it is difficult to do so, because of its aggressive behavior.2),5) Reviewed by Ceresoli et al.9) in 1997, cytology of pericardial effusion was diagnostic only in 67% of cases, while thoracotomy and biopsy yielded a positive result in all. Jurkovich

et al. in 2000 reported PCL diagnosed by percutaneous Inhibitors,research,lifescience,medical intracardiac biopsy with combined fluoroscopic and TEE imaging. Recently Higo et al.10) reported cardiac lymphoma diagnosed by intracardiac echocardiography-guided biopsy in 2009. Histologically, most of the tumors were B-cell neoplasms and were of diffuse large cell Inhibitors,research,lifescience,medical type.4) Although a gold standard therapy for cardiac lymphoma was still not established, surgery as well as systemic chemotherapy solely or in combination with irradiation is the main example therapeutic approaches. According to reviews, prompt anthracycline-based chemotherapy Cilengitide results in 61% of complete remission (mean follow-up times 17 months; range 3-40 months).1),4) Meanwhile, surgery did not seem to have improved the prognosis. In Korea, there were some case reports of PCL, most of them diagnosed by invasive method, including thoracotomy.11-13) Furthermore, when they chose the primary therapeutic approach as a mass reduction by open heart surgery, patients showed poor prognostic features.14),15) In our case, compared with previously reported cases, PCL was diagnosed by various modern imaging techniques and endomyocardial biopsy via percutaneous cardiac approach.