PMC4347798_01
Figure 1. A 77-year-old woman with breast cancer and an abnormal well-defined density in the left paratracheal region. A, Posteroanterior and B, Lateral chest X-rays
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In the pre-surgical chest X-ray, there was an abnormal well-defined density in the left paratracheal region above the aortic arc with deviation of the trachea to the right (Figure 1).
CT scan of the neck and chest, A-D: Axial view, E: Sagittal view, F: Coronal view. CT scan of the neck and chest shows a normally located thyroid gland (*) and the distinct location of the ETT (**).
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The scan demonstrated round, hypodense nodular changes in the parenchyma of the left lobe of the thyroid gland (Figure 2). The mass was not in direct continuity with the normally located pretracheal thyroid gland (Figure 2 E and F).
CT scan demonstrates a large anterior mediastinal mass on the left side of the aortic arch (arrow). A, Axial view; B, Coronal view; C, Axial CT images taken during the CT-guided punch biopsy procedure show the path of the semi-automated biopsy system.
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It showed heterogeneous contrast enhancement of the ETT mass which is not in direct continuation with the normally located thyroid gland (Figure 3 A and B). Tc-99m-HDP bone scan that showed no evidence of bone metastasis. The mass was then biopsied with a semi-automated core biopsy system (G 16) under CT guidance (Figure 3 C) for histopathological evaluation.
A, Low-power view of the biopsy specimen demonstrating normal thyroid tissue (H & E, original magnification 30x, B and C, High-power view reveals a normally appearing thyroid follicular epithelium filled with colloid material (H & E original magnification 200x)
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The histopathological examination of the biopsy revealed normal thyroid parenchyma (Figure 4).