Case Of the Week (COW) 26 May 2013
Answer:
THYMOLIPOMA
Findings:
Radiograph: Homogenous radio opacity obliterating right cardiophrenic angle - broad based towards mediastinum – clear margins with adjacent lung. Retrosternal air space is replaced by a homogenous radio opacity in lateral view. Density of the lesion parallel with density of subcutaneous fat.
CT: predominant fatty attenuation anterior mediastinal lesion with few linear septations traversing. MRI: T1 and T2 hyperintense and suppressed on fat suppressed sequences.
Discussion:
Thymolipoma is a rare, benign, slow-growing tumor that accounts for 2%–9% of all thymic neoplasms. It occurs most frequently in young adults and has no sex predilection. Usually asymptomatic and manifests as a large anterior mediastinal mass. Because of its soft and pliable nature, thymolipoma typically drapes itself around the heart and adjacent mediastinal structures, often becoming quite large before coming to clinical attention. It is usually detected incidentally at routine chest radiography and may occasionally mimic cardiac enlargement or an elevated hemidiaphragm . At CT and MR imaging, thymolipoma manifests as a fatty mass with fibrous septa . Association with myasthenia gravis, Graves disease, aplastic anemia, and other hematologic disorders has been reported .
REFERENCE: Radiographics - 2006
Contributed By:
Dr.Sampath kumar, Dr.Manimekala, Prof. Babupeter
Barnard Insitute of Radiology
Answer:
THYMOLIPOMA
Findings:
Radiograph: Homogenous radio opacity obliterating right cardiophrenic angle - broad based towards mediastinum – clear margins with adjacent lung. Retrosternal air space is replaced by a homogenous radio opacity in lateral view. Density of the lesion parallel with density of subcutaneous fat.
CT: predominant fatty attenuation anterior mediastinal lesion with few linear septations traversing. MRI: T1 and T2 hyperintense and suppressed on fat suppressed sequences.
Discussion:
Thymolipoma is a rare, benign, slow-growing tumor that accounts for 2%–9% of all thymic neoplasms. It occurs most frequently in young adults and has no sex predilection. Usually asymptomatic and manifests as a large anterior mediastinal mass. Because of its soft and pliable nature, thymolipoma typically drapes itself around the heart and adjacent mediastinal structures, often becoming quite large before coming to clinical attention. It is usually detected incidentally at routine chest radiography and may occasionally mimic cardiac enlargement or an elevated hemidiaphragm . At CT and MR imaging, thymolipoma manifests as a fatty mass with fibrous septa . Association with myasthenia gravis, Graves disease, aplastic anemia, and other hematologic disorders has been reported .
REFERENCE: Radiographics - 2006
Contributed By:
Dr.Sampath kumar, Dr.Manimekala, Prof. Babupeter
Barnard Insitute of Radiology