Micronodular Thymoma with Lymphoid Stroma: A Mediastinal Mass Masquerading as a Pericardial Mass

A 61-year-old man presented to the emergency room with lower extremity edema. Physical exam was only remarkable for a diastolic murmur in the right carotid area and left lower extremity edema. Venous Doppler revealed a deep venous thrombosis in the left lower extremity. Chest computed tomography (CT...

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Main Authors: Kent Swimley, Hilda M. Gonzalez-Bonilla, Alpana Senapati, Karla M. Kurrelmeyer
Format: Article
Language:English
Published: Houston Methodist DeBakey Heart & Vascular Center 2021-10-01
Series:Methodist DeBakey Cardiovascular Journal
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Online Access:https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/516
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author Kent Swimley
Hilda M. Gonzalez-Bonilla
Alpana Senapati
Karla M. Kurrelmeyer
author_facet Kent Swimley
Hilda M. Gonzalez-Bonilla
Alpana Senapati
Karla M. Kurrelmeyer
author_sort Kent Swimley
collection DOAJ
description A 61-year-old man presented to the emergency room with lower extremity edema. Physical exam was only remarkable for a diastolic murmur in the right carotid area and left lower extremity edema. Venous Doppler revealed a deep venous thrombosis in the left lower extremity. Chest computed tomography (CT) with intravenous contrast ruled out pulmonary embolism but showed a mediastinal mass adjacent to the pericardium. Further imaging with cardiac magnetic resonance imaging (CMR) and cardiac CT angiography (CCTA) enabled localization and evaluation of the structural characteristics of the mass. The decision was made to excise the mass due to increasing size compared with its measurements on prior chest CTs and a high degree of vascularization seen on CMR and CCTA, which was concerning for an enlarging arteriovenous malformation or a hemangioma. However, histopathologic analysis of the mass revealed it to be a micronodular thymoma.
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issn 1947-6108
language English
publishDate 2021-10-01
publisher Houston Methodist DeBakey Heart & Vascular Center
record_format Article
series Methodist DeBakey Cardiovascular Journal
spelling doaj-art-bd85cdbf312e4491a9082e4036e648a92025-08-20T02:22:19ZengHouston Methodist DeBakey Heart & Vascular CenterMethodist DeBakey Cardiovascular Journal1947-61082021-10-01173182310.14797/mdcvj.516560Micronodular Thymoma with Lymphoid Stroma: A Mediastinal Mass Masquerading as a Pericardial MassKent Swimley0https://orcid.org/0000-0002-4835-6642Hilda M. Gonzalez-Bonilla1https://orcid.org/0000-0002-1879-6647Alpana Senapati2https://orcid.org/0000-0002-5525-4038Karla M. Kurrelmeyer3https://orcid.org/0000-0001-5685-3879Houston Methodist Hospital, Houston, TexasHoward University Hospital, Washington, DCIntermountain Heart Institute Cardiology-Intermountain Medical Center, Murray, UtahHouston Methodist Hospital, Houston, Texas; Houston Methodist DeBakey Cardiology Associates, Houston, TexasA 61-year-old man presented to the emergency room with lower extremity edema. Physical exam was only remarkable for a diastolic murmur in the right carotid area and left lower extremity edema. Venous Doppler revealed a deep venous thrombosis in the left lower extremity. Chest computed tomography (CT) with intravenous contrast ruled out pulmonary embolism but showed a mediastinal mass adjacent to the pericardium. Further imaging with cardiac magnetic resonance imaging (CMR) and cardiac CT angiography (CCTA) enabled localization and evaluation of the structural characteristics of the mass. The decision was made to excise the mass due to increasing size compared with its measurements on prior chest CTs and a high degree of vascularization seen on CMR and CCTA, which was concerning for an enlarging arteriovenous malformation or a hemangioma. However, histopathologic analysis of the mass revealed it to be a micronodular thymoma.https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/516micronodular thymomalymphoid stromamediastinal mass
spellingShingle Kent Swimley
Hilda M. Gonzalez-Bonilla
Alpana Senapati
Karla M. Kurrelmeyer
Micronodular Thymoma with Lymphoid Stroma: A Mediastinal Mass Masquerading as a Pericardial Mass
Methodist DeBakey Cardiovascular Journal
micronodular thymoma
lymphoid stroma
mediastinal mass
title Micronodular Thymoma with Lymphoid Stroma: A Mediastinal Mass Masquerading as a Pericardial Mass
title_full Micronodular Thymoma with Lymphoid Stroma: A Mediastinal Mass Masquerading as a Pericardial Mass
title_fullStr Micronodular Thymoma with Lymphoid Stroma: A Mediastinal Mass Masquerading as a Pericardial Mass
title_full_unstemmed Micronodular Thymoma with Lymphoid Stroma: A Mediastinal Mass Masquerading as a Pericardial Mass
title_short Micronodular Thymoma with Lymphoid Stroma: A Mediastinal Mass Masquerading as a Pericardial Mass
title_sort micronodular thymoma with lymphoid stroma a mediastinal mass masquerading as a pericardial mass
topic micronodular thymoma
lymphoid stroma
mediastinal mass
url https://account.journal.houstonmethodist.org/index.php/up-j-mdbcj/article/view/516
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AT hildamgonzalezbonilla micronodularthymomawithlymphoidstromaamediastinalmassmasqueradingasapericardialmass
AT alpanasenapati micronodularthymomawithlymphoidstromaamediastinalmassmasqueradingasapericardialmass
AT karlamkurrelmeyer micronodularthymomawithlymphoidstromaamediastinalmassmasqueradingasapericardialmass