EURORAD ESR

Case 14391

An Unusual Cause of Dyspnoea in a Young Patient: Myeloid Sarcoma

Author(s)
Hynes, J., O'Brien, C., Govender, P., Torregiani, W.

Department of Radiology, Tallaght Hospital, Dublin, Ireland. Email:johynes@tcd.ie
 
Patient
female, 17 year(s)
 
 
  • Figure 1
    PA erect chest radiograph

    PA erect chest radiograph; an enlarged heart with a rounded contour consistent with a large pericardial effusion. Bilateral costophrenic angle blunting is in keeping with pleural effusions. The lungs are clear.

     
    Area of Interest: Mediastinum; Imaging Technique: Digital radiography; Procedure: Computer Applications-General; Special Focus: Haematologic diseases;
     
     
  • Figure 2
    CTPA
     

    Axial Computed tomography pulmonary angiogram (CTPA) at the level of the pulmonary trunk. There is narrowing of both main pulmonary arteries secondary to large mediastinal soft tissue mass.

     
    Area of Interest: Mediastinum; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Special Focus: Haematologic diseases;

    Axial CTPA at the level of the superior mediastinum, the soft tissue mass is demonstrated encasing the main branch aortic vessels and trachea. The trachea is slightly deviated to the right.

     
    Area of Interest: Lung; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Special Focus: Haematologic diseases;

    Coronal CTPA showing a massive pericardial effusion and soft tissue mass extending into the superior mediastinum encasing the visualized mediastinal vasculature. Left pleural effusion noted.

     
    Area of Interest: Mediastinum; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Special Focus: Haematologic diseases;

    Sagittal CTPA at the level of the aortic arch, a large soft tissue mass in the anterior and superior mediastinum encases the aorta, its branching vessels and the left main bronchus.

     
    Area of Interest: Mediastinum; Imaging Technique: CT-Angiography; Procedure: Contrast agent-intravenous; Special Focus: Haematologic diseases;
     
     
  • Figure 3
    CT guided biopsy

    CT guided biopsy of the mediastinal mass

     
    Area of Interest: Mediastinum; Imaging Technique: CT; Procedure: Biopsy; Special Focus: Haematologic diseases;
     
     
  • Figure 4
    CT thorax post IV dexamethasone and chemotherapy

    CT Thorax with intravenous contrast post treatment with high dose intravenous steroids and systemic chemotherapy (daunorubicin and cytosine arabinoside) with significant reduction in size of the superior mediastinal...

     
    Area of Interest: Mediastinum; Imaging Technique: CT; Procedure: Contrast agent-intravenous; Special Focus: Haematologic diseases;
     
     
PA erect chest radiograph; an enlarged heart with a rounded contour consistent with a large pericardial effusion. Bilateral costophrenic angle blunting is in keeping with pleural effusions. The lungs are clear.
 
Axial Computed tomography pulmonary angiogram (CTPA) at the level of the pulmonary trunk. There is narrowing of both main pulmonary arteries secondary to large mediastinal soft tissue mass.
 
Axial CTPA at the level of the superior mediastinum, the soft tissue mass is demonstrated encasing the main branch aortic vessels and trachea. The trachea is slightly deviated to the right.
 
Coronal CTPA showing a massive pericardial effusion and soft tissue mass extending into the superior mediastinum encasing the visualized mediastinal vasculature. Left pleural effusion noted.
 
Sagittal CTPA at the level of the aortic arch, a large soft tissue mass in the anterior and superior mediastinum encases the aorta, its branching vessels and the left main bronchus.
 
CT guided biopsy of the mediastinal mass
 
CT Thorax with intravenous contrast post treatment with high dose intravenous steroids and systemic chemotherapy (daunorubicin and cytosine arabinoside) with significant reduction in size of the superior mediastinal soft tissue mass.
 
 
 
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