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Hepatic and renal cysts are relatively common among healthy people, but there are few published reports of primary cysts of the atrial septum. Here, we report a case of an unusual cyst of the atrial septum accompanied by atrial septal defect (ASD) in a 42‐year‐old woman. Microscopic examination showed the deposition of calcium salts within the tissue mass and an organized thrombus surrounded by a fibrous capsule. The case was discussed with reference to the relevant published literature and compared to other documented types of atrial septal cysts. The final diagnostic conclusion was a primary atrial septal cyst. [ABSTRACT FROM AUTHOR]

Background: So far, there have been more than 761 million confirmed cases of SARS-CoV-2 worldwide, with more than 6.8 million deaths. The most common direct causes of death for COVID-19 are diffuse alveolar injury and acute respiratory distress syndrome. Autopsy results have shown that 80-100% of COVID-19 patients have microthrombi which is 9 times higher than in patients with influenza. There are reported cases of fat embolism associated with Covid-19, but relevant epidemiological investigations and fatal cases of pulmonary fat embolism are lacking. In this report, we describe the first COVID-19 patient to die from pulmonary fat embolism. Case presentation: A 54-year-old woman suddenly felt unwell while at work. She had difficulty breathing for 40 min and lost consciousness for 20 min before being taken to the hospital. On admission, her temperature was 36 ℃, but her respiration, heart rate, and blood pressure were undetectable. Laboratory examination revealed C-reactive protein, 26.55 mg/L; D-dimer, 11,400 µg/L; and procalcitonin, 0.21 ng/mL. She was declared clinically dead 2 h after admission due to ineffective rescue efforts. At autopsy, both lungs were highly oedematous with partial alveolar haemorrhage. The presence of microthrombi and pulmonary fat embolism in small interstitial pulmonary vessels was confirmed by phosphotungstic acid haematoxylin staining and oil red O staining. The immunohistochemical results of spike protein and nucleocapsid protein in laryngeal epithelial cells confirmed SARS-CoV-2 infection. Conclusions: Pulmonary fat embolism may be another fatal complication of COVID-19 infection, and clinicians should pay more attention to it. [ABSTRACT FROM AUTHOR]