Presentation
Cough with retrosternal chest pain.
Patient Data
The scout view demonstrates a left-sided anterior mediastinal mass with obtuse angles with the left mediastinal contour.
The CT scan demonstrates a heterogeneously enhancing left-sided anterior mediastinal soft tissue mass with lobulated contour in contact with the pulmonary trunk and left ventricle with moderate pericardial thickening. No other mediastinal mass or lymphadenopathy. No pleural effusion. Both lungs were clear (lung window not shown).
No distant abdominal or pelvic metastasis.
Other findings:
simple right renal cyst
small accessory spleen
small duodenal diverticulum
prostatic hypertrophy.
right inguinal hernia
On the MRI exam, the mediastinal mass elicits an isosignal to muscle on T1, high signal on T2 and T2 fat sat with progressive heterogeneous enhancement. No evidence of myocardial or pericardial invasion.
CT-guided biopsy showing the needle within the mediastinal mass.
Case Discussion
CT and MRI features of a heterogeneously enhancing left-sided anterior mediastnal mass with no distant metastasis.
The patient went on to have a CT-guided biopsy that confirms the diagnosis of a diffuse large B-cell lymphoma which is considered the most common subtype of non-Hodgkin lymphoma.
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