Anterior Mediastinal Bone-Eroding Mass With Disseminated Lung Lesions

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Anterior Mediastinal Bone-Eroding Mass With Disseminated Lung Lesions Roopa Siddaiah, MBBS, Mark Weinblatt, MD, Jon Roberts, MD, FCCP, Mary Cataletto, MD, FCCP CHEST Volume 140, Issue 5, Pages 1371-1376 (November 2011) DOI: 10.1378/chest.10-2027 Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 1 Plain chest radiographs demonstrate nodular densities of the bilateral lung fields with mediastinal widening (arrows). A, Posteroanterior view. B, Left lateral view. CHEST 2011 140, 1371-1376DOI: (10.1378/chest.10-2027) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 2 A, Axial CT image of the thorax with IV contrast shows marked compression on the left brachiocephalic vein. Paratracheal adenopathy is also noted (white arrow). B, View in bone window shows a relatively large, heterogenous soft tissue mass that has eroded the posterior wall of the manubrium (black arrows in A and B). CHEST 2011 140, 1371-1376DOI: (10.1378/chest.10-2027) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 3 Axial and coronal lung windows show multiple small and predominantly peripheral cavitary pulmonary nodules (arrows). A, Axial window. B, Coronal lung window. CHEST 2011 140, 1371-1376DOI: (10.1378/chest.10-2027) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 4 Image of the distal right femur shows a scalloping lytic lesion with a sclerotic border in the right medial metaphysis. CHEST 2011 140, 1371-1376DOI: (10.1378/chest.10-2027) Copyright © 2011 The American College of Chest Physicians Terms and Conditions

Figure 5 A, Cellular infiltrate consisting of Langerhans cells showing irregular nuclei with nuclear grooves admixed with eosinophils (hematoxylin-eosin, original magnification ×400). B, Immunohistochemical stain for CD1a (original magnification ×400). CHEST 2011 140, 1371-1376DOI: (10.1378/chest.10-2027) Copyright © 2011 The American College of Chest Physicians Terms and Conditions