Presentation
Dyspnoea
Patient Data









A large anterior mediastinal soft tissue mass lesion showing heterogeneous enhancement. No calcification or fat attenuation.
The mass invades and occludes the left brachiocephalic vein which drains via thoraco-abdominal collaterals. Tumour bulges into the SVC, narrowing it and extends into the jugular vein.
Moderate right pleural effusion with no nodularity. Small pericardial effusion.
Otherwise normal. Normal thyroid gland. No lymphadenopathy. Normal adbomen.
Histopathology revealed lymphoma of high grade B cell type.
Case Discussion
The main differential diagnoses include malignant thymic tumours such as carcinoma, carcinoid or lymphoma, malignant germ cell tumour or the rare NUT midline carcinoma.