PMC10282769_01
The chest CT mediastinum window showed a huge lump (see the arrow) compressing the liver, the lump's internal density was uneven, with extensive calcification-like high-density shadows, and the 10th rib on the right was invaded and destroyed by the lump.
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The lump compressed the liver, but the boundary between the lump and the liver was clear (see Figure 1).
The lump (see the arrow) presented a high signal with a clear boundary between the lump and the lung, but the lump margin was rough and characterized by destruction (MRI T2-weighted images).
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CT results. Chest diffusion-weighted imaging (DWI) showed that the lump grew on the 10th rib and presented uneven enhancement (DWI images high signal), and the liver was significantly compressed, but no abnormal signal was observed in the liver (see Figure 2).
The right chest wall presented a shadow (see the arrow) of abnormal radiation accumulation (whole-body bone imaging 3 h after intravenous injection of 99mTc-MDP).
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Whole-body bone imaging revealed an abnormal circular concentration shadow of radiation on the right chest wall, and the radiation uptake ability was significantly increased (see Figure 3).
The lump presents an irregular spherical shape. The inside appears as grid-like and honeycomb-like vascular tissue after incision (A); each grid is 1 x 1 cm in size). The tissue slices show enlarged blood vessels, a large number of red blood cells in the blood vessels, and transparent fibrous matrix around the blood vessels (B); hematoxylin and eosin staining original, x40).
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A firm, well-circumscribed mass with dimensions of 8.2 cm x 8.0 cm x 7.1 cm was found arising from the medullary cavity of the 10th rib (Figure 4A). According to a microscopic examination of the lump, it consisted of irregularly distorted blood vessels without outward signs of necrosis or pleomorphism (Figure 4B).