PMC5567976_01
Computed tomography and surgical findings at initial treatment of the mediastinal cyst 2 years previously. A) Computed tomography revealed a cystic lesion in the upper mediastinum. B) A mediastinal cyst containing serous fluid was located adjacent to the superior vena cava and superior to the azygos vein. C) Histopathological examination confirmed the diagnosis of a celomic cyst. D) Immunohistochemistry revealed that the epithelium was D2-40 positive.
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Follow-up CT revealed enlargement of the mass (Fig. 1A). The mediastinal tumor was resected via video-assisted thoracoscopic surgery (Fig. 1B). Pathological diagnosis revealed the mass to be a mediastinal celomic cyst (Fig. 1C). Additional immunohistochemical evaluation following the patient's recovery revealed that the epithelium was D2-40-positive and negative for CD31 and CD34, leading to the diagnosis of a thoracic duct cyst (Fig. 1D).
Diagnostic findings at admission. A) Chest radiography revealed an enlarged cardiac silhouette with signs of fluid in the right hemithorax. B) Chest computed tomography revealed fluid collection in the upper mediastinum with pleural and pericardial effusion. (C) Yellowish-white fluid was obtained at pericardiocentesis.
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Chest radiography showed an enlarged cardiac silhouette and fluid in the right hemithorax (Fig. 2A). Chest CT revealed fluid collection in the upper mediastinum; there was also fluid in the pericardium and the thoracic cavity (Fig. 2B). A catheter was placed in the pericardium by a cardiologist, and 190 ml of yellowish-white fluid was drained (Fig. 2C).