PMC9666274_01
Distended veins over the chest along with subcostal and intercostal recessions.
can-16-1457fig1.jpg
PMC9666274_01_can-16-1457fig1.jpg
figure1
There were visible dilated veins over the upper part of the chest but there was no peri-orbital puffiness or upper limb oedema (Figure 1).
CT scan chest: A soft-tissue density lesion involving the anterior mediastinum extending down to left para-cardiac location. It collectively measures 41 x 50 x60 mm (anteroposterior x craniocaudal x transverse) and causing compression of the left main stem bronchus and collapse consolidation of almost the whole of the left lung.
can-16-1457fig2.jpg
PMC9666274_01_can-16-1457fig2.jpg
figure2
CT chest confirmed an anterior mediastinal mass (Figure 2) and the flow cytometry showed a mononuclear cell population (blasts) in peripheral blood with the prominent expression of cluster of differentiation 10 (CD10), CD19, CD79a, Anti Terminal deoxynucleotidyl transferase (Tdt), Human Leukocyte Antigen - DR isotype (HLA-DR), Anti Kappa and Anti Lambda, suggestive of precursor B ALL. Cytogenetics was not done due to unaffordability.