Mediastinal Masses, Anterior

Figure 27 : Nodular sclerosing Hodgkin's lymphoma. A, Close-up view of posteroanterior chest radiograph in a 14-year-old girl with asymptomatic cervical lymphadenopathy shows large anterior mediastinal mass widening both sides of mediastinum (arrows). Trachea (asterisk) is slightly shifted to the left side. B, Contrast-enhanced CT scan at level of second thoracic vertebra shows right supraclavicular and cervical lymphadenopathy with homogeneous enhancement (arrows). C, CT scan at level of main bronchi shows paratracheal and tracheobronchial lymphadenopathy with heterogeneous enhancement and areas of cystic changes (arrow) and homogeneous, well-marginated thymic mass (T) with anterior mediastinal lymphadenopathy. Superior vena cava (arrowhead) is displaced anteriorly, but is patent. D, Low-power view shows fibrous collagen bands completely surrounding each cellular nodule and subdividing tumor into multiple discrete nodules. (Hematoxylin-eosin stain.) E, High-power view shows confluent infiltrate of large neoplastic cells with pleomorphic nuclei and pale cytoplasm, typical of lacunar variants of Reed-Sternberg cells. (Hematoxylin-eosin stain.) F, CD30 stain shows cytoplasmic staining of lacunar cells. a, ascending aorta; e, esophagus.

Mediastinal Lymphoma

Mediastinal lymphoma usually manifests as a large anterior mediastinal mass resulting in widening of the mediastinum (Fig. 25 and Fig. 26). Approximately 40% of cases manifest as enlargement of a single nodal group. Bulky anterior mediastinal lymphad ...

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