A case of pulmonary vein obstruction: evaluation using newer echocardiographic imaging techniques

A 59-year-old woman was admitted in our hospital due to persistentcough and dyspnea. Transthoracic 2-dimensional echocardiographydemonstrated a cardiac mass (29x34 mm) that extended from theright upper pulmonary vein into the left atrium causing thepartial obstruction of the right lower vein as indicated bythe increased Doppler velocities. Contrast echocardiographyconfirmed the presence of microcirculation within the mass.During transesophageal (TEE) echocardiographic study, colorDoppler imaging and power Doppler imaging (Angio^® Vivid7, GE Medical System, Horten, Norway) demonstrated the presenceof vascular flow within the mass. A chest magnetic resonancetomography showed a pulmonary mass of 30x25x28 mm infiltratingthe pulmonary veins. After surgery, biopsy confirmed a highgrade mucoepidermoid lung cancer with few large arterioles.The new echocardiographic techniques can reliably differentiatea cardiac tumor from a cardiac thrombus.