A case of malignant pericardial mesothelioma misdiagnosed as tuberculosis pericarditis

Primary pericardial mesothelioma is an extremely rare neoplasm with a bleak prognosis. It is often misdiagnosed as constrictive0apericarditis initially, especially as tuberculosis pericarditis in Korea due to the high incidence of active tuberculosis. A targeted pericardial0abiopsy and noninvasive imaging modalities, such as delayed phase contrast chest computed tomography (CT) images and0amagnetic resonance imaging (MRI), can play an important role in the differential diagnosis of pericardial disease. We present the0acase of a 37-year-old man with a 3-week history of exertional dyspnea. A large pericardial effusion with pericardial thickening was0anoted, but its etiology was not revealed after conventional diagnostic procedures, including a closed pericardial biopsy. Empirical0aantituberculosis treatment was started, but the dyspnea recurred 5 months later. A malignant pericardial mesothelioma was diagnosed0athrough a pericardiectomy and biopsy under direct visualization.ope