Weekly Chest CasesImaging Conference Cases

Case No : 2

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  • Age/Sex 32 / M
  • Case Title Coughing and chest discomfort for one month
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Diagnosis With Brief Discussion

Imaging Findings
Operative Findings


Anterior mediastinal mass ( 5x3cm sized, tan-colored, hard, well-defined)

Abutting the thymus, separated from pericardium and mediastinal pleura.
Discussion
Mesenchymal cell origin quasineoplastic lesion
1) Heterogeneous chronic inflammatory cell - plasma cell, lymphocyte, histiocyte.
2) Spindle shaped cell - myofibroblast
Immunostaining - vimentin, actin, desmin
Found nearly every site of the body - Lung(m/c), orbit, heart, GI tract, CNS, etc.
Calcification, cavitation(rare), Locally aggressive, multiple

Unknown etiology

- also associated with surgery, infection, malignancy, autoimmune disease, etc.
Wide age range of incidence - most common in children or young adults
No sex and racial predilection
Usually asymptomatic : detected incidentally

Chest Radiograph
?peripheral located, sharply circumscribed mass

CT

?well marginated solid mass, heterogeneous attenuation, variable pattern of enhancement.

MRI
?intermediate SI on T1, increase SI on T2.

Treatment
- conservative surgery
- steroid
- chemotherapy, RTx, antiinflammatory drugs

Can recur after complete resection
Reference
Mesenchymal cell origin quasineoplastic lesion
1) Heterogeneous chronic inflammatory cell - plasma cell, lymphocyte, histiocyte.
2) Spindle shaped cell - myofibroblast
Immunostaining - vimentin, actin, desmin
Found nearly every site of the body - Lung(m/c), orbit, heart, GI tract, CNS, etc.
Calcification, cavitation(rare), Locally aggressive, multiple

Unknown etiology

- also associated with surgery, infection, malignancy, autoimmune disease, etc.
Wide age range of incidence - most common in children or young adults
No sex and racial predilection
Usually asymptomatic : detected incidentally

Chest Radiograph
?peripheral located, sharply circumscribed mass

CT

?well marginated solid mass, heterogeneous attenuation, variable pattern of enhancement.

MRI
?intermediate SI on T1, increase SI on T2.

Treatment
- conservative surgery
- steroid
- chemotherapy, RTx, antiinflammatory drugs

Can recur after complete resection
Keywords
Mediastinum, Non-infectious inflammation, anterior mediastinum,
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