Presentation
Dyspnea
Patient Data
A large right-sided mediastinal opacity, with patchy areas of coarse calcification.
Irregular right diaphragmatic surface.
A large right-sided mediastinal soft tissue mass lesion with internal coarse calcifications. It is compressing right main bronchus, displacing ascending aorta to left, completely invading superior vena cava with dilated azygos venous system. It is compressing right atrium with reflux of contrast on inferior vena cava, which is dilated.
Multiple enlarged cardio-phrenic lymph nodes as well as multiple mediastinal lymph nodes, largest at aorto-pulmonary window.
Multiple fissural and pleural-based soft tissue lesions at the right hemithorax, at the right oblique fissure, right upper and lower thoracic zones, largest related to right lung base invading the right hemidiaphragm and indenting hepatic dome, suggestive of multiple pleural metastases.
Hepatomegaly. Multiple abdominal para-aortic and mesenteric lymph nodes.
Case Discussion
Histologically proven to be a thymoma with pleural and nodal metastases and invasion of the superior vena cava.
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