PMC2816898_01
PA radiographs of the chest shows a huge, well marginated, homogeneous mass in the anterior mediastinum displacing the lower trachea, bronchus and heart contralaterally.
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F1
Erect posteroanterior and lateral radiographs of the chest showed a well marginated anterior mediastinal mass in the entire right lung zone, compressing the lower trachea, right bronchus, and heart toward the left side (Fig. 1).
(A) Chest CT scan at the level of aortic origin demonstrates a huge, low attenuating, cystic mass in anterior mediastinum with internal septa and heterogeneous solid area anteromedially. (B) Contrast enhanced CT scan shows the focal solid mass area with heterogeneous enhancement anteromedially and irregular margin between the mass and anterior chest wall and pericardium.
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F2
Direct invasion of the anterior chest wall and pericardium by the mass was suggested, because pericardial fat plane was obliterated and the margin between the mass and the adjacent right anterior chest wall and pericardium was indistinct (Fig. 2).
Photomicrograph (H-E stain, x40) shows tumor cells forming cords or solid sheets within the fibrous stroma. Three cellular compositions; intermediate, squamous, and mucous cells are noted. Small spaces filled with mucus are also present.
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F3
Histologically, squamoid tumor cells formed cords or solid sheets within the fibrous stroma admixed with mucin-secreting epithelium lining gland-like spaces (Fig. 3).