Fig. 1

Transesophageal echocardiogram, computed tomography chest scan and histology of the biopsied right paratracheal lymph node mass. Low-middle transesophageal echocardiogram views (Panel A and B) showing a hyperechoic and irregular mass attached to the atrial aspect of the mitral valve, scallops A1/A2 (7 × 4 mm), without valve obstruction or dysfunction (Panel A, apical four-chamber view, 0º and Panel B, two-chamber view, 60º). CT chest scan imaging revealed an isolated right paratracheal lymph node mass, with 60 × 37x36 mm (Panel C). Hematoxylin and eosin staining of the biopsied lymph node mass showed a lymphoid neoplasia composed of predominantly large cells distributed in a diffuse pattern. The neoplastic cells reveal an eosinophilic cytoplasm with irregular contours and pleomorphic nuclei, showing variable hyperchromasia (Panel D)