Images in clinical medicine | Volume 37, Article 162, 15 Oct 2020 | 10.11604/pamj.2020.37.162.26304

Giant mediastinal mass

Danilo Coco, Silvana Leanza

Corresponding author: Danilo Coco, Department of General Surgery, Ospedali Riuniti Marche Nord, Pesaro, Italy

Received: 29 Sep 2020 - Accepted: 10 Oct 2020 - Published: 15 Oct 2020

Domain: Thoracic surgery

Keywords: Keywords: Giant mediastinal mass, mediastinal lymphoma B-Cells, computed tomography (CT)

©Danilo Coco et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Danilo Coco et al. Giant mediastinal mass. Pan African Medical Journal. 2020;37:162. [doi: 10.11604/pamj.2020.37.162.26304]

Available online at: https://www.panafrican-med-journal.com/content/article/37/162/full

Home | Volume 37 | Article number 162

Images in clinical medicine

Giant mediastinal mass

Giant mediastinal mass

Danilo Coco1,&, Silvana Leanza2

 

1Department of General Surgery, Ospedali Riuniti Marche Nord, Pesaro, Italy, 2Department of General Surgery, Carlo Urbani Hospital, Jesi, Ancona, Italy

 

 

&Corresponding author
Danilo Coco, Department of General Surgery, Ospedali Riuniti Marche Nord, Pesaro, Italy

 

 

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A 43-year-old Caucasian female presented to the ED with significant dyspnea, thoracic pain and fever. She presented a negative medical history and no therapy. During the physical examination, the patient was uncomfortable. Her vital signs were: blood pressure, 100/90 mmHg; respiratory rate, 50 breaths/minute; heart rate, 130 beats/minute; and temperature superior of 38°C. Oxygen saturation was 80% on room air and 90% with the aid of oxygen. The abdominal examination was unremarkable. Laboratory evaluation revealed high leukocytosis with a white blood cell (WBC) count of 15 per mm3. Arterial Blood Gases (ABG) demonstrated respiratory acidosis: PO2 80, PCO2 60, HCO3 30 mEq. Thoracic X-ray revealed a massive plural effusion. Computed tomography demonstrated a giant mediastinal mass surrounding pulmonary artery, aorta and pericardia pleura associated with massive pleural effusion. The patients immediately started intravenous (IV) fluids of 2l in 6 hours, Foley and jugular catheter vein cannulation to support main arterial pressure and urine output. The patient was transferred to surgical services where a 28 Fr thoracic drainage was inserted. Post-drainage Thoracic Scan (TC) demonstrated only the giant mediastinal mass. FNA CT scan guided was performed. Hysto-patological findings were mediastinal lymphoma B-Cells. The patient was discharged three day after.

 

 

Figure 1: A) thoracic Computed Tomography (CT) scan demonstrated a giant mediastinal mass associated with massive left pleural effusion; B) post-28 Fr thoracic drainage demonstrated the extention of giant mediastinal mass; C) FNA thoracic TC scan biopsy

 

 

 

 

 

 

 

 

 

 

 

 

Images in clinical medicine

Giant mediastinal mass

Images in clinical medicine

Giant mediastinal mass

Images in clinical medicine

Giant mediastinal mass

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Keywords: Giant mediastinal mass

Mediastinal lymphoma B-Cells

Computed tomography (CT)

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