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An 18-year-old female presented with complaints of breathlessness on exertion for the past 6 months. Systemic examination was normal. Echocardiography showed a large hyperechoic well-defined right atrial mass occupying the entire right atrium and extending up to tricuspid valve. Mild pericardial effusion was noted. Visualized portions of pulmonary arteries were normal. Contrast-enhanced computed tomography (CT) chest demonstrated a lobulated heterodense mass occupying the anterior mediastinum which infiltrated superior vena cava and extended into right atrium up to the tricuspid valve. Histopathological examination through CT = guided biopsy and immunohistochemistry confirmed the mediastinal mass as B-cell lymphoma. The patient was started on chemotherapy as per medical oncologist opinion. Despite chemotherapy, the patient succumbed to unexplained sudden death.