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  Your answer (C) is not the one that we were looking for. (D) is correct!

   It is true that the patient's clinical picture and positive blood cultures are consistent with bacterial endocarditis, and that the right atrial mass could represent a large vegetation. However, the homogenous and the "soft" echogenic appearance, filamentous projects and varying contour are more in keeping with a large right atrial thrombus in this patient with chronic atrial fibrillation.
   An underlying vegetation probably served as a nidus for the thrombus but is not felt to account for the entire mass.

All the other options listed in the previous question are true.
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