Case 13           Home Next Case

FINDINGS:

The mediastinum is widened to both sides,from the level of the clavicles to the upper heart. The widening is irregular and nodular, not smooth or circular. On the lateral, there is marked opacity above the heart, where the mediastinum is usually very narrow, producing lucency. The trachea is deviated posterior.

PATTERN:

The abnormal opacity satisfies the definition of a mass

DIFFERENTIAL DIAGNOSIS:

The appearance is that of an anterior mediastinal mass. The possible causes are most likely to be thymic masses, teratoid (stem cell) masses and lymphomas. Chest CT is the preferred next study, but MRI was performed first in this case, and is an acceptable alternative.

DIAGNOSIS:

Hodgkin’s Disease, nodular sclerosing type

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CORRELATION:

One advantage of MRI is the ability to image in any plane. Here, the sagittal view shows the mass filling and expanding the anterior mediastinum. The irregularity of the border favors lymphoma, but the diagnosis was only established by pathology.

FINDINGS

PATTERN

DIFFERENTIAL DIAGNOSIS

DIAGNOSIS AND CORRELATION

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