PMC3797656_01
Computed Tomography of the chest shows the presence of an anterior mediastinal solid mass (red arrow) that has a maximum diameter of 7.5 cm. This tumor has a fine line of separation from adjacent vascular structure and back side of the sternum and rib cartilage.
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figure1
A computed tomography (CT) scan of the thorax showed an anterior mediastinal tumour, with no evidence of spreading to adjacent tissue (Figure 1).
(A) Solid tumor made up of lymphocytes with germinal center formation. (B) At higher magnification, (arrow) large cells of clear eosinophilic cytoplasm and round nuclei (epithelial cells) are also observed. (C) The tumor has invaded the pleura, passing through it. (D) The tumor has invaded the mediastinal adipose tissue. (E) In the hypocellular bone marrow only megakaryocytes (big arrow) and myeloid elements are observed (short arrow). (F) Immunohistochemical staining against glycophorin C is only positive on red cells; no erythroid precursor-like cells are observed.
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figure2
A biopsy of the surgical piece showed type B1 thymoma, according to the World Health Organization (WHO) classification, with infiltration into the sub-pericardial connective tissue and mediastinal adipose tissue, associated with pulmonary implants (Figure 2AD) Masaoka stage III. He was given a transfusion of red blood cells, and a bone marrow biopsy was performed, showing typical findings consistent with pure red cell aplasia. (Figure 2E,F).
Computed Tomography of the chest shows left pleural nodular thickening predominantly in costophrenic recesses, identifying large tumors at this level (red arrow). Multiple left juxta-cisural nodules up to 13 mm (yellow arrow).
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figure3
The chest CT (Figure 3) showed left nodular pleural thickening, associated with pulmonary ipsilateral and adenopathic mediastinal nodules, compatible with a diagnosis of tumour recurrence.