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Thymoma

Case contributed by Frank Gaillard
Diagnosis certain

Patient Data

Age: Adult
Gender: Male
x-ray

Soft tissue density projecting to the left of the mediastinum. The distal part of the arch and proximal descending aorta can be seen as separate suggesting it is located anterior to these structures.

mri

MRI confirms the presence of an anterior mediastinal mass without convincing macroscopic invasion. 

Case Discussion

The patient went on to have a resection. 

Histology:

The tumor is a thymoma of the cortical type.

The mass is firm and covered anterolaterally with a thin translucent membrane, consistent with mediastinal pleura. The cut surface is yellow-tan in color with variably sized lobulation and focal hemorrhagic/degenerative areas in the central portion.

There is extension of the tumor into the surrounding mediastinal fat, outside of the tumor capsule, and this qualifies as an invasive thymoma. The tumor tends to push the mediastinal pleural margin and the pericardial structures. There is no evidence of pericardial involvement.

FINAL DIAGNOSIS: thymoma.

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