PMC4748782_01
CT scan showing large heterogeneous left-sided pleural effusion.
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F1
A CT scan of the chest showed a large effusion on the left with some loculation inferomedially (fig. 1).
Large gelatinous mass with bleeding into the pleural cavity as seen on video-assisted thoracoscopic surgery.
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F2
With a high suspicion for hemorrhagic effusion, he underwent video-assisted thoracoscopic surgery which revealed a large 12.5 x 8.0 cm gelatinous mediastinal mass with bleeding into the pleural cavity (fig. 2).
Myxoid stroma with high mitotic activity and pleomorphism. Tumor cells are seen at 400x magnification.
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F3
A biopsy of the mass revealed myxoid stroma with pleomorphic cells and atypical nuclei with high mitotic activity most consistent with myxofibrosarcoma (fig. 3).