More than just the "Q-tip sign".

In the early days of transesophageal echocardiography, the "Q-tip sign" was occasionally mistaken for a left atrial mass. This area is now well recognized as a normal anatomic landmark dividing the left atrial appendage from the left upper pulmonary vein. However, in this report we describe 2 patients in whom pathology was found in this area, which should not be overlooked.