PMC7773822_01
Preoperative examination and intraoperative status of the patient. (A) The thoracic contrast-enhanced CT showed that the mass was located in the right posterior mediastinum, and its size was approximately 40*35 mm. The CT value of the plain scan was approximately 46 HU, and the CT value was approximately 130 HU after enhancement. (B, C) Endobronchial ultrasonography showed that a posterior mediastinal mass was located far from the carina with a complete capsule, clear margin and adequate blood supply. (D, E) During the operation, the lesion was located under the carina and surrounded by several abnormally large bronchial arteries, which had an extremely abundant blood supply. (F) The mass was completely removed and was approximately 3.5 cm in size.
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Thoracic contrast-enhanced computed tomography (CT) showed that a 40*35 mm mass was located in the posterior mediastinum, and it was clinically diagnosed as Castleman's disease ( Figure 1A ). Endobronchial ultrasonography showed that the posterior mediastinal mass was located far from the carina with a complete capsule, clear margin, and adequate blood supply ( Figures 1B, C ). During the operation, the lesion was located under the carina with five abnormally large bronchial arteries ( Figures 1D, E ). Fortunately, by gradually mobilizing the surrounding tissue of the mass and carefully ligating these bronchial arteries with the Hem-o-lok clips, the mass was completely removed ( Figure 1F ).
Histopathological examination of tissue samples (hematoxylin-eosin, original magnification, A: x100, B: x200). The tumor cells were positive for CD10 (C), vimentin (D), PAX-2 (E), PAX-8 (F), CK-Pan (G), and the RCC marker (H) (immunohistochemistry, original magnification, x200).
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Postoperative pathological examination indicated that the mass was a right mediastinal malignant tumor ( Figures 2A, B ). Immunohistochemical staining showed that the tumor cells were positive for cluster of differentiation 10 (CD10), vimentin, paired box 2 (PAX-2), paired box 8 (PAX-8), CK-Pan, and RCC markers but negative for cytokeratin 7 (CK 7), CgA, CD56, and synaptophysin (Syn) ( Figures 2C-H ).