Micronodular Thymoma with Lymphoid Stroma: A Mediastinal Mass Masquerading as a Pericardial Mass

Kent Swimley; Hilda M. Gonzalez-Bonilla; Alpana Senapati; Karla M. Kurrelmeyer

doi:10.14797/mdcvj.516

Micronodular Thymoma with Lymphoid Stroma: A Mediastinal Mass Masquerading as a Pericardial Mass

Kent Swimley, Hilda M. Gonzalez-Bonilla, Alpana Senapati, Karla M. Kurrelmeyer

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

A 61-year-old man presented to the emergency room with lower extremity edema. Physical exam was only remarkable for a diastolic murmur in the right carotid area and left lower extremity edema. Venous Doppler revealed a deep venous thrombosis in the left lower extremity. Chest computed tomography (CT) with intravenous contrast ruled out pulmonary embolism but showed a mediastinal mass adjacent to the pericardium. Further imaging with cardiac magnetic resonance imaging (CMR) and cardiac CT angiography (CCTA) enabled localization and evaluation of the structural characteristics of the mass. The decision was made to excise the mass due to increasing size compared with its measurements on prior chest CTs and a high degree of vascularization seen on CMR and CCTA, which was concerning for an enlarging arteriovenous malformation or a hemangioma. However, histopathologic analysis of the mass revealed it to be a micronodular thymoma.

Original language	English (US)
Pages (from-to)	18-23
Number of pages	6
Journal	Methodist DeBakey cardiovascular journal
Volume	17
Issue number	3
DOIs	https://doi.org/10.14797/mdcvj.516
State	Published - 2021

Keywords

lymphoid stroma
mediastinal mass
micronodular thymoma

ASJC Scopus subject areas

Medicine(all)

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10.14797/mdcvj.516

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title = "Micronodular Thymoma with Lymphoid Stroma: A Mediastinal Mass Masquerading as a Pericardial Mass",

abstract = "A 61-year-old man presented to the emergency room with lower extremity edema. Physical exam was only remarkable for a diastolic murmur in the right carotid area and left lower extremity edema. Venous Doppler revealed a deep venous thrombosis in the left lower extremity. Chest computed tomography (CT) with intravenous contrast ruled out pulmonary embolism but showed a mediastinal mass adjacent to the pericardium. Further imaging with cardiac magnetic resonance imaging (CMR) and cardiac CT angiography (CCTA) enabled localization and evaluation of the structural characteristics of the mass. The decision was made to excise the mass due to increasing size compared with its measurements on prior chest CTs and a high degree of vascularization seen on CMR and CCTA, which was concerning for an enlarging arteriovenous malformation or a hemangioma. However, histopathologic analysis of the mass revealed it to be a micronodular thymoma.",

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AU - Senapati, Alpana

AU - Kurrelmeyer, Karla M.

PY - 2021

Y1 - 2021

N2 - A 61-year-old man presented to the emergency room with lower extremity edema. Physical exam was only remarkable for a diastolic murmur in the right carotid area and left lower extremity edema. Venous Doppler revealed a deep venous thrombosis in the left lower extremity. Chest computed tomography (CT) with intravenous contrast ruled out pulmonary embolism but showed a mediastinal mass adjacent to the pericardium. Further imaging with cardiac magnetic resonance imaging (CMR) and cardiac CT angiography (CCTA) enabled localization and evaluation of the structural characteristics of the mass. The decision was made to excise the mass due to increasing size compared with its measurements on prior chest CTs and a high degree of vascularization seen on CMR and CCTA, which was concerning for an enlarging arteriovenous malformation or a hemangioma. However, histopathologic analysis of the mass revealed it to be a micronodular thymoma.

AB - A 61-year-old man presented to the emergency room with lower extremity edema. Physical exam was only remarkable for a diastolic murmur in the right carotid area and left lower extremity edema. Venous Doppler revealed a deep venous thrombosis in the left lower extremity. Chest computed tomography (CT) with intravenous contrast ruled out pulmonary embolism but showed a mediastinal mass adjacent to the pericardium. Further imaging with cardiac magnetic resonance imaging (CMR) and cardiac CT angiography (CCTA) enabled localization and evaluation of the structural characteristics of the mass. The decision was made to excise the mass due to increasing size compared with its measurements on prior chest CTs and a high degree of vascularization seen on CMR and CCTA, which was concerning for an enlarging arteriovenous malformation or a hemangioma. However, histopathologic analysis of the mass revealed it to be a micronodular thymoma.

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KW - mediastinal mass

KW - micronodular thymoma

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Micronodular Thymoma with Lymphoid Stroma: A Mediastinal Mass Masquerading as a Pericardial Mass

Abstract

Keywords

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