A rare mediastinal tumour in a young male mimicking massive pleural effusion (original) (raw)

Patient With Slow-Growing Mediastinal Mass Presents With Chest Pain and Dyspnea

Chest, 2016

A 52-year-old white woman presented with severe pain over the right upper abdomen and nonpleuritic, right-sided, lower chest-wall pain. Her pain had progressively gotten more frequent and severe over the last 5 months. It was also associated with a nonexertional, pressure-like sensation in the central chest. The patient denied any shortness of breath, fevers, cough, or any sputum production. She was taking levothyroxine for hypothyroidism and was a 30-pack-year current smoker; there was no history of drug abuse or occupational exposure. Previous chest radiographs dating back to 5 years consistently showed an elevated right-sided hemidiaphragm without any infiltrates or effusions; cardiomediastinal structures were unremarkable. She had not had a previous workup for these abnormal findings.

A Mediastinal Mass: A Case of Acute Mediastinitis Posing as A Lymphoma

2019

A 22-year-old Caucasian man presented to the hospital with chest pain and fevers of one-week duration. His symptoms started after experiencing a loud eructation while drinking beer followed by retrosternal chest pain. He denied any tobacco or drug use. He had no recent travel or significant exposures. He had a history of childhood asthma and no surgical history. On examination, patient had a temperature of 38.5 °C, heart rate of 122 bpm and blood pressure of 95/48 mmHg. The remaining physical exam was unremarkable. Laboratory work up revealed a neutrophilic (82.5%) predominant leukocytosis of 18,000/μL. Electrocardiogram, chest radiograph and serum Troponin T were normal. A computed tomography angiography (CTA) of the chest revealed a soft tissue mediastinal mass involving the subcarinal region (figure 1) concerning for lymphoma. A bronchoscopy with endobronchial ultrasound -guided transbronchial needle aspiration of the subcarinal mass revealed evidence of inflammation with necrosi...

Giant Benign Mediastinal Masses Extending into the Pleural Cavity

The Surgery Journal, 2016

Introduction The aim of the study was to evaluate the results of surgery to remove huge mediastinal masses and their pathology. Surgical resection was chosen for accurate diagnosis and treatment of the huge mediastinal masses extending into the pleural cavity. Methods Records were reviewed for eight patients who had the diagnosis of huge benign mediastinal masses and who underwent operation; details of the patients and operations were recorded. Results Mean age was 34.5 (range 22 to 44) years, and male-to-female ratio was 2:6. Computed tomography and magnetic resonance imaging (MRI) were used to evaluate the location and extent of the abnormality and to characterize the tissue components of the mass. Most of the tumors were located in the posterior mediastinum. The most frequent presenting symptom was exertional dyspnea. The majority of cases underwent posterolateral thoracotomy, and complete resection was possible in seven patients. Partial resection could only be performed in one....

Pleural and mediastinal malignancies : management and rare clinical cases

2011

printing supported by . Visit Chiesi at Stand D.30 MONDAY, SEPTEMBER 26TH 2011 normal apart from a high erythrocyte sedimentation rate (120 mm/hr), anemia (hb: 10.9 g/dl) and hypoxemia (PaO2: 48 mmHg). Computed tomography revealed multiple mediastinal lymph nodes, bilateral pleural thickenings, paramediastinal mass lesion in the left lower lobe and multiple pulmonary nodules. Cranial CT was normal. Abdominal USG revealed liver metastasis with multiple hypoechoic nodules 2 cm in diameter. Transbronchial biopsy via fiberoptic bronchoscopy revealed the diagnosis of malignant mesothelioma infiltration. The tumor was diffusely positive for calretinin and focal positive for keratin 5,6. The patient died one week after diagnosis. P2827 Benefit of the serum-effusion albumin gradient in congestive heart failure patients Piamlarp Sangsayunh1, Boonjong Saejueng2. 1Chest Department, Central Chest Institute of Thailand, Nonthaburi, Thailand; 2Cardiology Department, Central Chest Institute of Tha...

An unusual isolated anterior mediastinal lesion

Respirology case reports, 2022

Malignant pleural mesothelioma (MPM) is an infrequent tumour of poor prognosis with a strong association with asbestos exposure. Pleural effusion or thickening is the most common radiological finding. Thoracoscopic biopsy is the diagnostic modality of choice. In our report, we present the case of a career welder who consulted with vocal cord palsy and an atypical anterior mediastinal lesion. An EBUS-TBNA-guided biopsy and a thorough cytological assessment led to an unexpected diagnosis of epithelioid MPM. A localized anterior mediastinal lesion is an extremely infrequent presentation of MPM that deserves clinical recognition.

An unusual case of mediastinal mass with pleural and pericardial effusion

Indian Journal of Pathology and Oncology, 2023

Background: Myeloid sarcoma is a tumor mass consisting of myeloid blasts, with or without maturation, occurring in an anatomical site other than bone marrow. More than 2000 case reports so far, only few comprehensive studies have been done, which reflects the rarity and difficulties in treatment of this neoplasm. Case Report: A 17-year-old female presented with complaints of neck swelling since 2 months, breathlessness since 5 days. PET CT- Bilateral pleural and pericardial effusion Large mediastinal mass, multiple enlarged lymph nodes and appendicular skeleton showing increased FDG uptake. CT-Guided biopsy of the mediastinal mass: Uniform blue cells in sheets. IHC: CD45-Weak positive CD20, CD3, TdT-Negative CD99-Diffuse strong positive Parallelly, blood and bone marrow examination was done. Peripheral smear-80% blasts. Bone marrow-Monomorphous population of myeloblasts. Discussion: About 21% of Myeloid Sarcomas (MS) are reported to occur in the mediastinum. Clinical presentation is dependent on tumour location, with symptoms due to tumour mass effect or local organ dysfunction. Recent studies show a misdiagnosis of 25-47%, with Hodgkin's lymphoma, lymphoblastic lymphoma, DLBCL, Ewing's sarcoma, thymoma, round blue cell tumours, or poorly differentiated carcinomas, mostly due to inadequate immunophenotyping. It was not corrected until a diagnosis of acute leukaemia was later established by bone marrow biopsy or peripheral blood examination. Conclusion: Recognition of MS with/without AML is essential for prognosis. Correlating radiological, hematological, bone marrow and flowcytometry features with histomorphology and immunohistochemistry of the tumor is essential. A rare possibility of MS should be kept in mind for mediastinal masses for timely diagnosis and treatment. Keywords: Pericardial effusion, Myeloid sarcoma, Acute myeloid leukemia, Immunohistochemistry.

A 37-Year-Old Woman With an Incidentally Found Mediastinal Nodule*

CHEST Journal, 2008

A 37-year-old woman presented with a sudden onset of right-sided chest pain and dyspnea the day after she underwent an abdominal hysterectomy for excessive menstrual bleeding. The pain was constant and worsened with breathing. Medical history was significant for a splenectomy following a motor vehicle accident at the age of 9 years. She had a 20 -pack-year history of smoking. A pulmonary embolism was suspected. Multidetector-row spiral CT of the chest showed compression atelectasis of the basal segments of the right and left lower lobes but no pulmonary embolism. Unexpectedly, a well-circumscribed, homogeneously enhanced mediastinal nodule 15 mm in diameter was seen in the anterior superior mediastinum . With analgetic treatment, she was discharged free of symptoms on the seventh postoperative day. At the following visit to the Department of Pulmonary Diseases, she denied any complaints. Physical examination and laboratory findings were unremarkable. In addition to the known mediastinal nodule , conventional contrastenhanced chest CT revealed the presence of a pleural nodule 5 mm in diameter located anterolaterally in the left hemithorax . The patient underwent video-assisted thoracoscopic surgery. The mediastinal nodule seen on CT correlated with a reddish pedunculated nodule closely adherent to the left superior mediastinum . Several other, smaller pleuralbased lesions with a similar appearance were noted . The mediastinal nodule was resected and sent for pathologic examination . The other lesions were left intact.