Tumors of the Anterior Mediastinum A Report of Six Cases MILTON S. LLOYD, M.D., F.C.C.P.  Diseases of the Chest  Volume 14, Issue 3, Pages 396-414 (May 1948) DOI: 10.1378/chest.14.3.396 Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case I, Fig. 1 H.D., W.F., age 56. Posteroanterior view of the chest showing a large sharply demarcated mass in the right cardiophrenic angle. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case I, Fig. 2 A lateral projection of the chest locates the mass in the anterior mediastinum Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case I, Fig. 3 Posteroanterior view of chest seven months after operation. Note complete re-expansion of lung. Presenting symptoms had been absent since discharge. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case II, Fig. 1 R.M., W.M., age 4. Posteroanterior projection showing a mass occupying the lower half of the right pleural cavity. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case II, Fig. 2 A lateral projection localizes this mass in the anterior mediastinum. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case II, Fig. 3 Posteroanterior view of chest one year postoperative at which time the child was growing normally. (Photograph reversed in reproduction). Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case II, Fig. 4 Section of tumor—low power, showing large sinuses with coagulated serous content. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case II, Fig. 5 High power section of tumor showing connective tissue with scattered smooth muscle cells, giant cells and phagocytes. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case III, Fig. 1 Baby Boy K., W.M., new bom. Bronchoscopic view showing compression of the right stem bronchus by an external mass. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case III, Fig. 2 Anteroposterior projection showing sharply defined density in upper right chest cavity. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case III, Fig. 3 High power section of tumor showing “undifferentiated” cells in a fibrous stroma. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case IV, Fig. 1 H.N., W.M., age 10. Posteroanterior view of chest showing “residual effusion” in left base and displacement of heart to the right. (Previous x-ray, said to show obscurity of entire left hemithorax, not obtainable). Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case IV, Fig. 2 Section of tumor x460 showing adenomatous formations in a fibrous stroma together with columnar type epithelium suggesting bronchial of intestinal mucosa. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case IV, Fig. 3 Posteroanterior view showing condition of chest, three months postoperative at which time patient was clinically well. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case V, Fig. 1 B.R., WP., age 34. Admission x-ray showing large “abscess” cavity in left upper lobe with fluid level. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case V, Fig. 2 X-ray of chest two months after drainage of “abscess” and following lipiodol injection into cavity through external opening. Note multiple loculations and communication with bronchi. The two masses of lipiodol below the safety pin are outside the body. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case V, Fig. 3 Anteroposterior view of chest showing patient's condition six months after operation. At the time she was free of symptoms. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case V, Fig. 4 Microscopic section x200 showing variety and irregularity of structural formation from glandular type to cystic arrangements lined by cells of differing morphology. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case VI, Fig. 1 E.S., W.F., age 16. Posteroanterior view of chest showing a tumor occupying half the width of the thoracic cavity and beginning obscurity at the left base. This examination was made after deep x-ray therapy with no reduction in size of tumor. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case VI, Fig. 2 Posteroanterior view of chest after a second episode of “pleurisy.” Chest tap after this x-ray yielded 300 cc. of yellow turbid fluid sterile on culture. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case VI, Fig. 3 Lateral view of chest following evacuation of fluid. Note double fluid levels, one at the third rib anterior and one at the ninth rib posterior. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case VI, Fig. 4 Two way catheter used in this case for the maintenance of constant irrigation of the pleural cavity under constant negative pressure. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case VI, Fig. 5 Postoperative temperature record showing average elevation in the day periods beginning ten days before and ending thirty days after the use of parachlorophenol 1:1000 to mediastinal pyocyaneus infected wound. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case VI, Fig. 6 Posteroanterior projection of chest two months after discharge from hospital. The wound remained completely healed and the patient was symptom free. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions

Case VI, Fig. 7 Microscopic section of tumor demonstrating glandular formation with nearby hollow structure lined by bronchial type epithelium with underlying lymphoid tissue. Diseases of the Chest 1948 14, 396-414DOI: (10.1378/chest.14.3.396) Copyright © 1948 The American College of Chest Physicians Terms and Conditions