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Unusual lesions of the mediastinum.

Shamsuddin F, Khadilkar UN, Saha D - Lung India (2015 Nov-Dec)

Bottom Line: Of all the cases with malignant lesions, only the patient with SCC was alive after 1 year.Radiologic impression and knowledge of the compartment where these lesions arose from hardly assisted in arriving at a definitive opinion as the lesions were not typical of this location.A high index of suspicion and the immunohistochemical profile facilitated the final diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Malabar Medical College and Research Center, Kozhikode, Kerala, India.

ABSTRACT

Objectives: To study unusual lesions in the mediastinum, which do not originate from the thymus, lymph nodes, neural tissues or germ cells, and tissues that normally engender pathologic lesions in the mediastinum.

Materials and methods: Of the 65 cases seen, 12 unusual lesion were encountered in a 5½ year period from 2006 to 2011.

Results: Two cases of nodular colloid goiter and one each of the mediastinal cyst, undifferentiated carcinoma, and Langerhans cell histiocytosis (LCH) affected the anterosuperior mediastinum. In the middle mediastinum, one case each of the mesothelioma, malignant gastrointestinal stromal tumor (GIST), squamous cell carcinoma (SCC), solitary fibrous tumor (SFT), and pleomorphic sarcoma (PS) was seen. One case of meningeal melanocytoma (Mme) and primary pleural liposarcoma (PL) involved the posterior mediastinum. Persistent disease was seen in LCH after 2 years. Of all the cases with malignant lesions, only the patient with SCC was alive after 1 year.

Conclusion: The cases of primary and SCC, LCH, melanocytoma, liposarcoma and PS, and GIST are unexpected and very rarely have paradigms in the mediastinum. Radiologic impression and knowledge of the compartment where these lesions arose from hardly assisted in arriving at a definitive opinion as the lesions were not typical of this location. A high index of suspicion and the immunohistochemical profile facilitated the final diagnosis.

No MeSH data available.


Related in: MedlinePlus

(a) Computed tomography scan - soft tissue density mass 21 × 0.5 cm with areas of heterogenous nodular enhancement and necrosis in the entire left hemithorax. (b and c) (H and E, ×100 [b], H and E, ×400 [c]) elongated cells with oval nuclei in patternless pattern. (d) (×100) diffuse, strong positivity with CD34
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Figure 5: (a) Computed tomography scan - soft tissue density mass 21 × 0.5 cm with areas of heterogenous nodular enhancement and necrosis in the entire left hemithorax. (b and c) (H and E, ×100 [b], H and E, ×400 [c]) elongated cells with oval nuclei in patternless pattern. (d) (×100) diffuse, strong positivity with CD34

Mentions: SFT [Figure 5] was seen intraoperatively attached to the visceral pleura of the left lung compressing it. The solid-cystic mass on microscopy demonstrated dark, elongated, and somewhat hyperchromatic nuclei in ill-defined fascicles, prompting a diagnosis of neurofibroma. The characteristic vascular pattern was seen on review. CD34 positivity and S100 negativity favored the final verdict of SFT. The patient was alive and without disease at 1-year follow-up.


Unusual lesions of the mediastinum.

Shamsuddin F, Khadilkar UN, Saha D - Lung India (2015 Nov-Dec)

(a) Computed tomography scan - soft tissue density mass 21 × 0.5 cm with areas of heterogenous nodular enhancement and necrosis in the entire left hemithorax. (b and c) (H and E, ×100 [b], H and E, ×400 [c]) elongated cells with oval nuclei in patternless pattern. (d) (×100) diffuse, strong positivity with CD34
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663858&req=5

Figure 5: (a) Computed tomography scan - soft tissue density mass 21 × 0.5 cm with areas of heterogenous nodular enhancement and necrosis in the entire left hemithorax. (b and c) (H and E, ×100 [b], H and E, ×400 [c]) elongated cells with oval nuclei in patternless pattern. (d) (×100) diffuse, strong positivity with CD34
Mentions: SFT [Figure 5] was seen intraoperatively attached to the visceral pleura of the left lung compressing it. The solid-cystic mass on microscopy demonstrated dark, elongated, and somewhat hyperchromatic nuclei in ill-defined fascicles, prompting a diagnosis of neurofibroma. The characteristic vascular pattern was seen on review. CD34 positivity and S100 negativity favored the final verdict of SFT. The patient was alive and without disease at 1-year follow-up.

Bottom Line: Of all the cases with malignant lesions, only the patient with SCC was alive after 1 year.Radiologic impression and knowledge of the compartment where these lesions arose from hardly assisted in arriving at a definitive opinion as the lesions were not typical of this location.A high index of suspicion and the immunohistochemical profile facilitated the final diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Malabar Medical College and Research Center, Kozhikode, Kerala, India.

ABSTRACT

Objectives: To study unusual lesions in the mediastinum, which do not originate from the thymus, lymph nodes, neural tissues or germ cells, and tissues that normally engender pathologic lesions in the mediastinum.

Materials and methods: Of the 65 cases seen, 12 unusual lesion were encountered in a 5½ year period from 2006 to 2011.

Results: Two cases of nodular colloid goiter and one each of the mediastinal cyst, undifferentiated carcinoma, and Langerhans cell histiocytosis (LCH) affected the anterosuperior mediastinum. In the middle mediastinum, one case each of the mesothelioma, malignant gastrointestinal stromal tumor (GIST), squamous cell carcinoma (SCC), solitary fibrous tumor (SFT), and pleomorphic sarcoma (PS) was seen. One case of meningeal melanocytoma (Mme) and primary pleural liposarcoma (PL) involved the posterior mediastinum. Persistent disease was seen in LCH after 2 years. Of all the cases with malignant lesions, only the patient with SCC was alive after 1 year.

Conclusion: The cases of primary and SCC, LCH, melanocytoma, liposarcoma and PS, and GIST are unexpected and very rarely have paradigms in the mediastinum. Radiologic impression and knowledge of the compartment where these lesions arose from hardly assisted in arriving at a definitive opinion as the lesions were not typical of this location. A high index of suspicion and the immunohistochemical profile facilitated the final diagnosis.

No MeSH data available.


Related in: MedlinePlus