Lobular distributed ground-glass opacification due to metastatic cardiac angiosarcoma: High resolution CT, MIP, and pathologic findings

We report the case of a 48-year-old man with a recent history of cardiac tamponade, who presented 6 months later recurrent hemoptysis of small volume. The CT scan revealed a bilateral pulmonary infiltration associating areas of ground-glass opacification of lobular distribution and tiny pulmonary nodules. Maximum intensity projection reconstructions were useful to better characterize the pulmonary infiltrates highlighting the CT halo sign. Contrast enhanced CT depicted a mass involving the right atrium and pericardium, confirmed by cardiac MRI. The surgical biopsy allowed radiological–pathological correlation revealing epithelioid angiosarcoma of the right atrium with pulmonary metastases.