Best Cases from the AFIP
Thymoma1
Leopoldo Santana, MD,
Amparo Givica, MD and
Carmen Camacho, MD
1 From the Department of Radiology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain. Received April 25, 2002; revision requested May 24 and received July 1; accepted July 9. Address correspondence to L.S., C/ Tomas Morales N° 97, 6° D, 35004 Las Palmas de Gran Canaria, Spain (e-mail: leosan43@hotmail.com).
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Figure 1a. (a) Posteroanterior chest radiograph shows a well-defined soft-tissue mass with sharp and lobulated borders at the left cardiophrenic angle. It is attached to the left ventricle (silhouette sign), simulating left-sided cardiac enlargement. These findings are compatible with an extraparenchymal lesion. No calcifications or air-fluid levels are seen. (b) Lateral chest radiograph shows that the soft-tissue mass is extraparenchymal and rounded and is located in the anteroinferior mediastinum (projecting over the cardiac silhouette). No infiltration of the adjacent structures is seen.
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Figure 1b. (a) Posteroanterior chest radiograph shows a well-defined soft-tissue mass with sharp and lobulated borders at the left cardiophrenic angle. It is attached to the left ventricle (silhouette sign), simulating left-sided cardiac enlargement. These findings are compatible with an extraparenchymal lesion. No calcifications or air-fluid levels are seen. (b) Lateral chest radiograph shows that the soft-tissue mass is extraparenchymal and rounded and is located in the anteroinferior mediastinum (projecting over the cardiac silhouette). No infiltration of the adjacent structures is seen.
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Figure 2. Echocardiogram shows that the mass is paracardiac and cystic. It has good through transmission, and a nodule is attached to the posterolateral wall.
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Figure 3. Contrast-enhanced CT scan shows that the mass is rounded and is located in the anteroinferior mediastinum (left cardiophrenic angle); it measures 9 x 8.5 cm. The lesion has a predominant cystic component with some peripheral nodular areas that enhance. The left ventricle and the adjacent mediastinal fat are not infiltrated. No peripheral or central calcifications are seen.
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Figure 4. Contrast-enhanced CT scan shows that the lesion is well defined and compresses the normal pulmonary parenchyma. No infiltration is evident.
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Figure 5. Contrast-enhanced CT scan shows a soft-tissue mass in the anterosuperior mediastinum (arrowheads), which corresponds to a thymic rest.
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Figure 6. Photograph of the gross specimen shows the tumor encapsulated by a thick capsule. The inner surface is irregular with excrescences and nodules of tumorous tissue.
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Figure 7. Photomicrograph (original magnification, x400; hematoxylin-eosin stain) shows many active, large lymphocytes with a recognizable nuclear chromatin. There are also epithelial cells, which are polygonal with clear nuclei and small nucleoli.
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Figure 8a. Frontal (a) and lateral (b) postoperative radiographs show complete resolution of the mass.
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Figure 8b. Frontal (a) and lateral (b) postoperative radiographs show complete resolution of the mass.
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Copyright © 2002 by the Radiological Society of North America.
