Idiopathic/viral pericarditis. An 83-year-old male with history of coronary artery disease and hypertension presents to the emergency department with a 5-week history of fever and malaise. CECT performed for fever of unknown origin demonstrates pericardial enhancement and effusion (a–c), mediastinal lymphadenopathy (d), and a solid enhancing right renal mass (not shown). No cause for the patient’s pericarditis was found. Aspiration yielded occasional lymphocytes. Culture was negative. Fine needle aspiration of a mediastinal lymph node showed reactive cells. Symptoms gradually resolved on aspirin 325 mg daily. The patient’s incidentally discovered that renal cell carcinoma proved to be nonmetastatic by PET-CT which was performed later.
