PMC5322422_01
Anterior-posterior (AP) chest x-ray demonstrating marked enlargement of the cardiothymic silhouette.
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An anterior-posterior (AP) chest X-ray (Figure 1) performed in the emergency department demonstrated marked enlargement of the cardiothymic silhouette, which prompted further evaluation.
CT of chest/abdomen/pelvis demonstrated a homogeneously enhancing anterior mediastinal mass which maintained thymic contour, with mass effect upon the vessels and airway.
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fig2
A CT of chest/abdomen/pelvis (Figure 2) demonstrated a homogeneously enhancing anterior mediastinal mass which maintained thymic contour, with mass effect upon the vessels and airway.
Representative histology. Comparison of core biopsy specimen from the patient's mediastinal mass with histology of normal thymus. The 2x view demonstrates overall preservation of cortical and medullary regions, with the suggestion of increased RBC's in the patient sample compared to the normal specimen. This is better seen on the 40x view (arrows) and is consistent with hemorrhage into the thymic tissue. Asterisks mark normal Hassall's corpuscles, which can be seen in normal tissue and in cases of thymic hyperplasia. Cytokeratin staining in the patient is of normal intensity and distribution, ruling out the differential diagnosis of thymoma.
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fig3
Representative histology of the mass is shown in Figure 3.