Presentation
Shortness of breath.
Patient Data
CXR demonstrates a small to moderate left sided pleural effusion.
CT of the chest and abdomen demonstrating extensive lymph node enlargement, and confirming the pleural effusion.
CXR demonstrates complete white-out of the right hemi-thorax. Note the bulging of the azygo-esophageal recess towards the left, and shift of the mediastinum.
Case Discussion
This case elegantly illustrates a number of characteristic morhphology of lymphomatous nodes. In the upper abdomen they are seen to lift the aorta away from vertebral bodies. In the mesentary they encase the vessels, in the so-called sandwich sign.
This patient went on to have a biopsy which revealed a follicular lymphoma.
See article on lymphoma for further discussion.