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. 2020 Oct 1;10:16251. doi: 10.1038/s41598-020-73533-y

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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A 44-year-old man with ROS1-rearranged lung adenocarcinoma with pericardial and lymph node metastases. (a, b) Chest CT images demonstrate conglomerated metastatic lymph nodes in the right supraclavicular region (white arrows), which were shown to be metastatic adenocarcinoma from the lymph node core biopsy. Note the moderate amount of pericardial effusion (white arrow), which represents pericardial metastases. (c) Maximum intensity projection image of PET displays intense FDG uptake in the right supraclavicular and mediastinal lymph metastases (arrows). (d) Follow-up CT performed for marked hypotension illustrates an increased amount of pericardial effusion (arrow), which is consistent with impending cardiac tamponade.