Fig. 4
From: The imaging appearances of various pericardial disorders
A 51-year-old man with pathologically proven gastric lymphoma developed sudden onset of dyspnea and cardiac arrhythmia. Contrast-enhanced CT in the sagittal (a) and axial (b) planes demonstrates a gastropericardial fistula (black arrows) complicated with massive pneumopericardium (asterisks). Significant compressive effect to the heart is also noted (white arrows)