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A 22 year old woman was referred to our institution with shortness of breath and palpitations that had worsened over the preceding two weeks. She had also lost 10 kg in weight in the preceding eight months. On chest x ray, a large mediastinal mass was found. Transthoracic echocardiography revealed a large tumour infiltrating both atria, including a 20 × 20 mm growth in the right atria (white arrows, left panel) and mild pericardial effusion. The diagnosis of a diffuse large B cell lymphoma was reached following transbronchial biopsy. The patient underwent two cycles of CHOP chemotherapy (cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, vincristine 2 mg, and prednisone) within 14 days. Echocardiographic follow up 12 days after the second chemotherapy cycle showed complete remission of the large atrial mass of the right atria and both atrial walls (right panel). No pulmonary or cerebral embolism occurred, and no atrial septal defect or pericardial effusion were seen after chemotherapy.