A 67-year-old male was initially referred for CT scan of the chest, abdomen and pelvis for investigation of a systemic illness comprising anorexia, nocturnal night sweats and approximately 10 kg weight loss. He was previously in good health and lived independently with his family. No history of significant occupational exposure (e.g. asbestos) was present, but he may have been exposed to asbestos in farm outbuildings during his work as a farmer.
The patient had a long-standing history of atrial fibrillation and atrial flutter. Approximately 12 months prior to presentation, he developed symptoms of pericarditis and was found to have a pericardial effusion on echocardiogram without definite solid components. He was treated clinically at that time and no pericardiocentesis was performed. Therefore, it was not possible retrospectively to determine whether there was any evidence of malignancy at the time of the echocardiogram.