A bunch of grapes in the left ventricle

A 65-year-old man, heavy smoker, was admitted because of severe exertional dyspnea and vague chest pain for 2 weeks. A chest X-ray was taken and revealed a large mass in the left lung field (Figure 1). Cytological examination of the percutaneous needle aspiration of a lymph node in the anterior mediastinum revealed malignant epithelial cell nests which was strongly suggestive of squamous cell carcinoma. Transthoracic echocardiography was performed and revealed multiple mass-like lesions with central liquefactions in the left ventricle resembling a bunch of grapes.