Weekly Chest CasesArchive of Old Cases

Case No : 1123 Date 2019-05-06

  • Courtesy of Jae Wook Lee, Kyung Eun Shin, Jai Soung Park / Soonchunhyang University Bucheon Hospital
  • Age/Sex 53 / M
  • Chief Complaintincidentally detected mass on a chest radiograph
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5
  • Figure 6
  • Figure 7

Diagnosis With Brief Discussion

Diagnosis
Thymic atypical carcinoid
Radiologic Findings
Fig. 1-2 Chest PA/Lat shows well-demarcated large mass at anterior mediastinum.
Fig. 3-4 Chest CT with enhancement shows diffuse enhancing mass with multifocal internal low attenuated foci at anterior mediastinum.
Fig. 5-7 Chest MRI shows heterogeneous high signal intensity on T2WI, iso signal intensity on T1WI, diffuse enhancement on post-enhancement T1WI with foci of low signal intensity inside.
Brief Review
Thymic neuroendocrine tumours (NETs) are rare, constituting approximately 2–5% of all thymic epithelial tumours. Thymic carcinoids often behave aggressively and present as advanced disease due to the invasion of adjacent mediastinal structures, local recurrence or metastases.
Thymic carcinoids tend to be large masses with irregular contours, no capsule, heterogeneous intensity on T2 weighted images, heterogeneous enhancement and local invasion on CT or MRI. A necrotic or cystic component was often seen in atypical carcinoid. These radiological features mimic those of high-risk thymomas and/or thymic carcinomas.
References
Shimamoto A, Ashizawa K, Kido Y, Hayashi H, Nagayasu T, Kawakami A, et al. CT and MRI findings of thymic carcinoid. Br J Radiol. 2017;90:20150341.
Please refer to
Case 421
Keywords
Mediastinum, Thymic Carcinoid,

No. of Applicants : 68

▶ Correct Answer : 15/68,  22.1%
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Ajou University School of Medicine , Korea (South) JUNG YONG JUN
  • - Ajou University Hospital , Korea (South) KYUNGMIN LEE
  • - Other , Korea (South) SEONGSU KANG
  • - Seoul National University Hospital , Korea (South) Ju Gang Nam
  • - Ajou University Hospital , Korea (South) DAYOUNG KIM
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Ajou University Hospital , Korea (South) HYERIN KIM
  • - TB centre kasaragod. , India rikhy krishnan
  • - University of Tsukuba Hospital , Japan SODAI HOSHIAI
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Hamamatsu University Hospital , Japan YUKI HAYASHI
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Ajou University Hospital , Korea (South) YONG HO JANG
  • - Ajou University Hospital , Korea (South) YOO YOUNGJIN
▶ Correct Answer as Differential Diagnosis : 13/68,  19.1%
  • - The University of Kyoto Hospital , Japan TOMOAKI OTANI
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
  • - Kinki University Faculty of Medicine, , Japan MITSURU MATSUKI
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Cabinet Capricorne, clinique sainte-clotilde , Reunion FABIEN HO
  • - Fujieda Municipal General Hospital , Japan HAYATO NOZAWA
  • - Wuhan Union Hospital , China NANCHUAN JIANG
  • - Gifu University Hospital , Japan Yo Kaneko
  • - Seoul National University Hospital , Korea (South) SE WOO KIM
  • - Chonbuk National University Hospital , Korea (South) KUM JU CHAE
  • - , Korea (South) JANG SEONG WON
  • - Kizawa Memorial Hospital , Japan Shoji Okuda
  • - Ajou University Hospital , Korea (South) SUBIN HEO
▶ Semi-Correct Answer : 2/68,  2.9%
  • - CLINIQUE STE CLOTILDE , Reunion PATRICK MASCAREL
  • - , Japan YUMI MAEHARA
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