A 49-Year-Old Woman With Right Apical Thoracic Mass

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Presentation transcript:

A 49-Year-Old Woman With Right Apical Thoracic Mass Yevgeniy A. Linnik, MD, Dagmar Hoegemann Savellano, MD, Joseph D. Phillips, MD, Candice C. Black, DO CHEST Volume 152, Issue 6, Pages e133-e138 (December 2017) DOI: 10.1016/j.chest.2017.08.012 Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 1 Chest posteroanterior radiograph shows a large convex density at the medial right apex. CHEST 2017 152, e133-e138DOI: (10.1016/j.chest.2017.08.012) Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 2 CT scanning showed a well-circumscribed, homogeneous 6-cm mass at the medial apex of the right hemithorax with extension into the upper mediastinum along the trachea, in between the trachea and esophagus, and along the right subclavian vessels. CHEST 2017 152, e133-e138DOI: (10.1016/j.chest.2017.08.012) Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 3 T1-weighted MRI scan with spectral fat saturation after intravenous contrast enhancement showed diffuse heterogeneous enhancement of the mass. It confirmed its well-circumscribed borders without any evidence of invasion into adjacent structures. CHEST 2017 152, e133-e138DOI: (10.1016/j.chest.2017.08.012) Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 4 MRI showed a well-circumscribed, slightly heterogeneous mass, which was hypointense on T1-weighted images and hyperintense on T2-weighted images. CHEST 2017 152, e133-e138DOI: (10.1016/j.chest.2017.08.012) Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 5 The cut surface was white and semitranslucent with a gelatinous appearance, completely surrounded by a thin fibrous capsule. CHEST 2017 152, e133-e138DOI: (10.1016/j.chest.2017.08.012) Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 6 Monomorphic collagenous stroma between bland spindle cells with areas of myxoid background. Characteristic mature ganglion cells with ample granular cytoplasm and round smooth nuclei are seen in small groups. Hematoxylin-eosin stain. CHEST 2017 152, e133-e138DOI: (10.1016/j.chest.2017.08.012) Copyright © 2017 American College of Chest Physicians Terms and Conditions

Figure 7 The stroma was positive for S-100 immunoperoxidase stain, and the singly distributed cells were strongly positive for neurofilament immunoperoxidase stain. CHEST 2017 152, e133-e138DOI: (10.1016/j.chest.2017.08.012) Copyright © 2017 American College of Chest Physicians Terms and Conditions