Presentation
Acute dyspnoea.
Patient Data
Homogeneous opacity in the right mid and lower zones forming an obtuse angle with the mediastinum superiorly. The right heart border and medial right diaphragm are obscured (silhouette sign).
Normal pulmonary vessels are visible through the abnormality.
Large predominantly fatty mediastinal mass containing thick soft tissue strands. No calcification or fluid. The mass extends from the prevascular mediastinum to the right paracardiac region, displacing the right lung and pleura and causing mild compressive atelectasis. Otherwise there is no mass effect on the adjacent structures.
No evidence of local invasion or metastases.
Case Discussion
Connection with the normal location of the thymus, the large size and the presence of fibrous septa in a predominantly fatty mass are typical features of thymolipoma 1.
Paraneoplastic conditions such as myasthenia gravis, Graves disease and haematological disorders are rarely associated with thymolipoma..
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