Presentation
Chest pain worsened by breathing, elevated inflammatory markers and D-dimers. PE? Pneumonia? Tumor?
Patient Data
CT scout image already demonstrates striking widening of the upper mediastinum.
Diffuse, confluous 15-20 mm short diameter pathological lymph nodes throughout the mediastinum, particularly in the paratracheal and upper-anterior part, where a larger conglomerate can be observed.
An about 60 x 40 mm axial diameter spiculated intrapulmonary mass in right segment 5, smaller nodules elsewhere.
Findings are in line with a large right-sided pulmonary neoplasm and marked lymphadenomagely predominantly in the upper-anterior mediastinum, suggestive of pulmonary manifestations of lymphoma.
Case Discussion
Subsequent VATS biopsy confirmed Hodgkin lmyphoma (nodular sclerosing variant).
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