A patient with myelodysplastic syndrome, under the supervision of a hematologist, sent for chest X-ray for further examination of findings. 

An ultrasound examination performed from a ventral approach to the right parasternal area, where there is a bulky tumour mass pressing down on the heart, for illustration the ultrasound is supplemented with colour Doppler. Under sonographic guidance a biopsy was performed, histology confirmed lymphoma (definitive diagnosis diffuse large B-cell lymphoma IV.B stage).