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Weekly Chest CasesArchive of Old Cases

Case No : 740 Date 2012-01-02

  • Courtesy of Ji-Young Choo, Mi-Suk Shim / Seoul National University Hospital
  • Age/Sex 39 / M
  • Chief ComplaintIncidentally found abnormality on chest radiograph
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5
  • Figure 6
  • Figure 7
  • Figure 8

Figure 1.

Diagnosis With Brief Discussion

Diagnosis
Venous hemangioma
Radiologic Findings
1. Chest X-ray: Bulging opacity is noted in the right paratracheal area and left pericardial area
2. Chest CT: Low attenuating lesion involving middle and anterior mediastinum. This lesion encases arch vessels, aortic arch and pericardium. However, there’s no definite evidence of vascular obstruction or post obstructive dilatation. And it show homogenously low attenuation without definite enhancement.
3. Chest MR: Mediastinal mass shows bright high signal intensity on T2WIs and some dark signal intensity component is noted in the left side of the mass lesion. However there’s no enhancement on T1 contrast enhanced MR image, even the low SI component on T2WIs.
 Differential diagnosis: lymphangioma, capillary hemangioma
4. Bilateral mediastinal VATS excision:
• Tortous and dilated blood vessels
• Consistent with Venous Hemangioma
Brief Review
Mediastinal hemangiomas are rare vascular tumors, less than 0.5% of all the masses found in the mediastinum. It is composed of large interconnecting vascular spaces lined with flat endothelial cells, and the vascular spaces are filled with blood. And over 90% of these tumors are cavernous or capillary hemangiomas. And venous hamangiomas are extremely rare, approximately 1% of all mediastinal hemangioma.
The tumors are categorized according to the size of their vascular spaces as capillary, cavernous and venous hemangiomas.
References
Abe K, Akata S, Ohkubo Y, et al. Venous hemangioma of the mediastinum. European Radiology 2001; 11:73-75.
Keywords
mediastinum, benign tumor,

No. of Applicants : 110

▶ Correct Answer : 1/110,  0.9%
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
▶ Correct Answer as Differential Diagnosis : 5/110,  4.5%
  • - China Medical University ,Taiwan,R.O.C. , Taiwan Jun Jun Yeh
  • - Youngdong Hospital , Korea (South) Sang Min Lee
  • - Homs National Hospital , Syria Rami Abou Zalaf
  • - Asan Medical Center , Korea (South) Eunyoung Kim
  • - Private sector , Greece Vasilios Tzilas
▶ Semi-Correct Answer : 76/110,  69.1%
  • - University of British Columbia , Canada Amr Ajlan
  • - radiology , Iran barat borhani
  • - Fukuyama daiichi Hospital , Japan Mototsugu Saeki
  • - MASHHAD MEDICAL SCIENCE , Iran SEYEDMOHAMMADALI HAMEDSHAMAEE
  • - CH de la C�e Basque , France Paul ARDILOUZE
  • - Goa Medical College , India Paresh Desai
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - Sunchun university hospital, Bucheon , Korea (South) So Young Bae
  • - kyunghee medical center , Korea (South) An ji young
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Inha University Hospital , Korea (South) Ju Won Lee
  • - MASAN , Korea (South) Kim Sang Hyeon
  • - Song-do Hospital , Korea (South) Ji-young Yun
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - Kurashiki Seijin-byo Center , Japan Akihiro Tada
  • - Chiba University Hospital , Japan Hajime Yokota
  • - Cl�nica Alemana - Universidad del Desarrollo , Chile Patricio Maximiliano Latorre Brajovic
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - Hopital Louis Pradel Lyon , France Clement Proust
  • - hjhj , Iran mehdi saifi
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Chungnam national university , Korea (South) Se Yun
  • - Paramount Diagnostic & Research Centre , India Mahavir Swami
  • - radiologist, aditya imaging centre , India vivek patel
  • - Samsung Medical center , Korea (South) Hee Kang
  • - fmmc , India subas kandimalla
  • - Ewha Womans University Hospital , Korea (South) YOOKYUNG KIM
  • - Kyung Hee Universitiy Hospital at Gangdong , Korea (South) Seong Yun
  • - James Paget Hospital , U.K , United Kingdom nabil mahmood
  • - HSC , Brazil Diogo Pinheiro
  • - korea university , Korea (South) Hyelarn Lee
  • - Virgin Mary Hospital Burgas , Bulgaria VLADISLAV RUSINOV
  • - IRSA La Rochelle France , France Denis Chabassiere
  • - Doctors Hospital , Bahamas muneesh sharma
  • - Centre hospitalier Lyon Sud , France matthieu ROUSSET
  • - Ondokuz Mayis University , Turkey Cetin Celenk
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
  • - CHRU lille , France manuel toledano
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Hotel-Dieu Montreal , Canada nicolas gautier
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Az Osp Santa Maria Terni , Italy angelo carloni
  • - Korea university , Korea (South) SUMIN HA
  • - Hangang Sacred Heart Hospital , Korea (South) Eil Seong Lee
  • - NDMVP Nashik , India Imran Jindani
  • - Okayama university , Japan Mayu Uka
  • - Asan Medical Center , Korea (South) Sang Min Lee
  • - Asan Medical Center , Korea (South) Hye Jeon Hwang
  • - Asan medical center , Korea (South) Hyun Joo Lee
  • - Asan medical center , Korea (South) sang young oh
  • - Asan medical center , Korea (South) Jong Woo Kim
  • - Sejong general hospital , Korea (South) Dong Jae Shim
  • - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OOKUBO
  • - Seoul St Mary Hospital , Korea (South) Chae Lim
  • - XiangYa hospital , China Xia Yu
  • - Bupyong Serim Hospital , Korea (South) Hee Seok Choi
  • - Asan Medical Center , Korea (South) Ji Eun Kim
  • - Samsung medical center , Korea (South) Hyun Su Kim
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - KUMC ansan , Korea (South) kihwan kim
  • - McGill University , Canada Ben Smith
  • - Kohka Public Hospital , Japan Akitoshi Inoue
  • - IRSA , France, Metropolitan BIGOT
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - Soon Chun Hyang Seoul , Korea (South) Kim Youn
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - Mallinckrodt Institute of Radiology , United States Naganathan Mani
  • - Saint Malo , France jean-baptiste Noel
  • - CHU MONTPELLIER , France stephanie nougaret
  • - Shree Diagnostics , India amol jagdale
  • - Radnet Teleradiology Istanbul , Turkey Armagan Sarac
  • - All India Institute of medical sciences , India Justin Moses
  • - Pneumologia Universitaria, Policlinico di Bari , Italy Mario Damiani
  • - A.P.Chest hospital ,hyderabad , India bhaskar kakarla
  • - Vikram hospital , India Pravin Mahadevappa
  • - Emory University Department of Radiology , United States Travis Henry
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Current Editor : Sung Shine Shim, MD, PhD. Email : sinisim@ewha.ac.kr

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