PMC3350037_01
Chest radiographs, PA (a) and lateral views (b) show a well-defined mass in the anterior mediastinum.
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fig1
The chest radiograph (PA view) showed a well-defined radio opaque shadow with no calcification or cavitations with its medial border merging with the right border of the heart, which was suggestive of an anterior mediastinal mass (Figure 1(a)). Lateral view confirmed the anterior mediastinal location of the mass (Figure 1(b)).
Axial post-contrast CT scan of the chest showing areas of necrosis in the mass with adherence to the pericardium.
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fig2
An axial CT scan showed a heterogeneously enhancing right anterior mediastinal mass with areas of necrosis which was adherent to the pericardium (Figure 2).
Photomicrographs showing the spindle cell (a) and the epithelial components (b) of the neoplasm (x100, H&E).
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fig3
On microscopic examination, a biphasic neoplasm was noted with well formed glandular epithelial structures admixed with a spindle cell component (Figure 3).
Photomicrographs highlighting the glandular features of the tumour (a) with Alcian blue positivity in the lumen (b) (x400, H&E; x100, Alcian blue, resp.).
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fig4
The glandular spaces were lined by cuboidal cells with vesicular nuclei and moderate cytoplasm and showed eosinophilic secretions within their lumens which stained positively with the Alcian blue stain (Figure 4).
Immunohistochemistry showing positivity for EMA (a) and Bcl-2 (b) (x400 and x200, resp.).
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fig5
The spindle cell component stained strongly with vimentin and bcl-2 (Figure 5).