Pediatric Malignant Pericardial Effusion Differential Diagnoses

Updated: Jul 03, 2019
  • Author: Poothirikovil Venugopalan, MBBS, MD, FRCPCH; Chief Editor: Syamasundar Rao Patnana, MD  more...
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DDx

Diagnostic Considerations

Failure to diagnose and appropriately react to the presence of a pericardial effusion is a potential medicolegal pitfall. In addition to the conditions listed in the differential diagnosis, other problems to be considered include the following:

  • Drug-induced pericardial disease (eg, from hydralazine, isoniazid, or procainamide)

  • Purulent pericarditis

  • Radiation pericarditis

  • Tuberculous pericarditis

  • Uremic pericarditis

  • Doxorubicin- and daunorubicin-related pericarditis or myocardial dysfunction

  • Cystic lymphangioma

  • Effusion possibly related to pre–bone-marrow transplant drug conditioning

  • Malignant hepatic involvement with portal hypertension

  • Microvascular tumor spread in lungs with secondary pulmonary hypertension

  • Pericardial celomic cyst (unilocular)

  • Pericardial teratoma

  • Superior venacaval obstruction of any cause

  • Chylous or lymphatic pericardial effusions, whether (1) from congenital thoracic cystic hygroma with pericardial involvement, (2) occurring after surgery for congenital heart disease complicated by elevated venous pressures or trauma to the thoracic duct, or (3) developing secondary to obstruction of lymphatic drainage by mediastinal masses

Differential Diagnoses