PMC3440930_01
Xiao Shi, MD
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F1
CD4 count of 551 K/mm, and HIV-1 RNA load of 16784 copies/ ml. Chest X-ray demonstrated an abnormal contour along the right cardiomediastinal border [Figure 1].
Multilocular thymic cyst with follicular hyperplasia in a 47- year-old HIV+ female with cough and chest pain. Postero-anterior chest radiograph demonstrates an abnormal contour along the right cardiomediastinal border (arrow).
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F2
Subsequent computed tomography (CT) of the chest with contrast revealed a 7.1 x 2.7 x 8.8 cm lobulated low-attenuation mass with heterogeneous enhancement in the anterior mediastinum [Figures 2, 3].
Multilocular thymic cyst with follicular hyperplasia in a 47 year-old HIV+ female with an anterior mediastinal mass. Axial contrast enhanced chest CT at the level of the heart shows a 7.1 x 2.7 x 8.8 cm lobular lowattenuation mass with heterogeneous enhancement draped across the anterior mediastinum (arrow).
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F3
Subsequent computed tomography (CT) of the chest with contrast revealed a 7.1 x 2.7 x 8.8 cm lobulated low-attenuation mass with heterogeneous enhancement in the anterior mediastinum [Figures 2, 3].
Multilocular thymic cyst with follicular hyperplasia in a 47 year-old HIV+ female with an anterior mediastinal mass. Coronal contrast enhanced chest CT shows low-attenuation cystic areas and enhancing septations (arrow).
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F4
Surgical pathology following thymectomy revealed a multilocular, predominantly cystic structure, filled with turbid yellow to hemorrhagic colloidal material [Figure 4].
Multilocular thymic cyst with follicular hyperplasia. Gross thymectomy specimen from a 47- year-old HIV+ female weighs 180 gram and measures 14.5 cm from medial to lateral, 15 cm from superior to inferior and up to 3.5 cm from anterior to posterior. The gland is very lobulated in appearance with a moderate amount of attached adipose tissue. The gland appears encapsulated with a smooth and glistening pink-purple surface.
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F5
Walls of the cystic mass contained abundant lymphoid tissue with follicular hyperplasia and a prominent reactive germinal center, leading to the diagnosis of multilocular thymic cyst (MTC) with follicular hyperplasia [Figure 5].
Multilocular thymic cyst with follicular hyperplasia. Hematoxylin and Eosin staining of thymectomy specimen from a 47 year-old HIV+ female shows (a) Two adjacent cysts (left and right) and a large lymphoid follicle with a germinal center (arrow) (2x). (b) Cyst wall with columnar epithelium heavily infiltrated by lymphocytes (20x).
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F6
CT scan of the neck revealed bilateral enlargement of the parotid glands with innumerable cystic areas [Figure 6].