PMC2713836_01
Gorham's disease in a 38-year-old man with mediastinal lymphangioma.. A. Posteroanterior chest radiograph shows widening of the mediastinum and osteolysis of the proximal clavicles.. B, C. Contrast-enhanced CT scan demonstrates an anterior mediastinal mass of low attenuation, which infiltrates mediastinal fat and envelops adjacent structures. Lysis of the manubrium (arrow in B) is apparent and follow-up CT (C) after three months shows left pleural effusion.. D. Irregular-shaped dilated lymphatic spaces lined by attenuated endothelium are embedded in connective tissue stroma, and small lymphoid aggregates are dispersed in the stroma. These findings are compatible with cavernous lymphangioma (original magnification, x250; hematoxylin-eosin staining).
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F1
Posteroanterior chest radiographs obtained at admission showed bilateral widening of the mediastinum and resorption of the proximal clavicles and the sternal manubrium (Fig. 1A). Osteolysis of the clavicles and manubrium was noted (Fig. 1B). Pathologic examination revealed cavernous lymphangioma (Fig. 1D), and on the basis of the radiologic and clinical features, Gorham's disease was diagnosed. Follow-up examination indicated that in spite of radiation therapy (total dose 3060 cGy), the extent of the mass increased as bony destruction and pleural effusion progressed (Fig. 1C).