Presentation
Shortness of breath.
Patient Data
Large lobulated mediastinal mass is noted, similar to previous. Moderate left sided pleural effusion also unchanged.
No new consolidation. No pneumothorax.
Centrally hypodense lobulated anterior mediastinal mass is again noted. The portion of the mass superior to the pulmonary trunk and anterior to the aortic arch and left main pulmonary artery has decreased in size compared to previous imaging (not shown). There has been a reduction in the degree of soft tissue extending between the arch of the aorta and left main pulmonary artery. The portion of the mass anterior to the ascending aorta has increased in size measures 44 x 55 mm (AP x CC), previously 22 x 37 mm.
No other mediastinal lymphadenopathy. No hilar or axillary lymphadenopathy.
Band of atelectasis in the left lower lobe with the previously demonstrated nodule in the region is no longer present. No pleural effusion.
Right-sided internal jugular central venous catheter.
Conclusion: Mixed response in size of anterior mediastinal mass with reduction in the left-hand aspect of the tumor but an increase in the right-hand aspect of the tumor. Probably overall there is a slight reduction in the anterior mediastinal mass size. Left pulmonary nodule no longer seen.
Case Discussion
Mediastinal biopsy confirmed lymphoma.