What is the next step in the management of this patient?
Core biopsy of the anterior mediastinal mass.
There is a large soft tissue mass arising in the right anterior mediastinum, extending anteriorly through the chest wall and invading the inferior portion of the right pectoral muscles. The mass extends superiorly into the region of the right lung apex and inferiorly into the region of the right lung base. This is highly suggestive of a thymic or lymphatic tumour.
There is a pericardial effusion. Heart size is within normal limits. Bilateral pleural effusions, worse on the right. There is a focal area of atelectasis in the right lower lobe, adjacent to the previously mentioned mediastinal mass.