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Mediastinal lymphoma

Case contributed by Dr Ahmed Abdrabou


Dyspnea and cough with an abnormal chest X-ray.

Patient Data

Age: 4 years old
Gender: Female

Chest x-ray reveals a mediastinal mass projecting to the left side with hilum overlay sign and right pleural effusion.


A large soft tissue attenuation mass occupying the anterior mediastinal displaying homogenous attenuation with low density areas of cystic changes inside. It extends to the middle mediastinum to occupy the pretracheal space and involve the right hilum. Inferiorly it is inseparable from the anterior pericardium. Compression upon the SVC and encasement of aorta and great vessels are noted. There is also mild right costal pleural thickening and enhancement suggesting infiltration with mild pleural effusion and abdominal retrocaval lymph nodes.

Case Discussion

Differential diagnosis of an anterior mediastinal mass in children includes:

  • normal thymus
  • thymic hyperplasia and thymoma, thymolipoma, thymic cyst and carcinoma
  • lymphoma
  • teratoma
  • lipoma
  • lymphangioma
  • pleuropericardial cyst
  • Morgagni hernia
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Case information

rID: 24432
Published: 15th Aug 2013
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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