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. 2020 Sep;37(9):1473-1477.
doi: 10.1111/echo.14823. Epub 2020 Aug 10.

Mitral valve tuberculoma: Role of sequential multimodality imaging of an unusual intracardiac mass

Vickram Vignesh Rangaswamy  1 , Daljeet Kaur Saggu  1 , Krishnamraju Penmetcha  2 , Sachin Yalagudri  1 , Narasimhan Calambur  1
Affiliations

Mitral valve tuberculoma: Role of sequential multimodality imaging of an unusual intracardiac mass

Vickram Vignesh Rangaswamy et al. Echocardiography. 2020 Sep.

Abstract

We present an unusual intracardiac mass posing a diagnostic dilemma. A middle-aged male patient was referred for workup of a symptomatic cardiac mass involving the mitral valve. Multimodality imaging consisting of cardiac magnetic resonance (CMR) imaging and 18F-fluorodeoxyglucose positron emission computerized tomography (18FDG-PET) scan was utilized to further characterize the mass after initial echocardiographic identification. CMR imaging identified extent of valvular mass into the interatrial septum and basal portion of the interventricular septum. On 18FDG-PET scan, the intracardiac mass was found to be metabolically active. It also revealed the presence of FDG avid lymph nodes in the abdomen. Histology of the lymph node revealed active granulomatous inflammation suggestive of tuberculosis. Treatment with antitubercular therapy resulted in resolution of the mass and mitral regurgitation, avoiding surgery.

Keywords: Cardiac tuberculoma; cardiac FDG-PET; cardiac MRI; intracardiac mass; tubercular infective endocarditis; tuberculosis.

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References

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