What’s that in the right atrium?

We present an interesting case of a middle-aged male patient with recent diagnosis of diffuse large B-cell lymphoma, who underwent a staging CT scan that revealed hypoattenuated lesions in the right atrium initially suspicious of thrombi. They were not evidence on transthoracic echocardiography, but the transesophageal echocardiogram showed a large mobile mass infiltrating and extending the right atrium, interatrial septum and aortic root. This case further illustrates the excellent sensitivity and specificity of transesophageal echocardiography for intracardiac masses but also the importance of multimodality cardiac imaging to reach a diagnosis and guide management.