EURORAD ESR

Case 15436

Mediastinal non-Hodgkin lymphoma with cardiac involvement and cardiac chamber compression

Author(s)
Vinicius Carraro Do Nascimento (MD), Elisa Chia (MBBS), Yuranga Weerakkody (MBChB, FRANZCR)

Royal Perth Hospital;
Level 3, North Block,
Wellington Street
6000 Perth, Australia;
Email:vinicn@icloud.com
 
Patient
female, 88 year(s)
 
 
  • Figure 1
    Frotal radiograph
     

    Frontal projection showing abnormal mediastinal contours, with increased soft tissue density abutting the left hilum and right para-tracheal region (as demarcated by green curvilinear lines).

     
    Area of Interest: Cardiac; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Lateral projection outlining added increased soft tissue density overlying the anterior mediastinal space (as demarcated by a green curvilinear line).

     
    Area of Interest: Cardiac; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;
     
     
  • Figure 2
    Axial contrast-enhanced CT images
     

    Axial contrast-enhanced CT image showing the cranial aspect of the anterior mediastinal mass (as demarcated by green curvilinear line).

     
    Area of Interest: Cardiac; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Axial contrast-enhanced CT image showing the anterior mediastinal mass (as demarcated by green curvilinear lines).

     
    Area of Interest: Cardiac; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Axial contrast-enhanced CT image showing the lobulated anterior mediastinal mass, encasing the great vessels (as demarcated by green curvilinear lines).

     
    Area of Interest: Cardiac; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Axial contrast-enhanced CT image shows the lobulated anterior mediastinal mass (as demarcated by green curvilinear line).

     
    Area of Interest: Cardiac; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Axial contrast-enhanced CT image shows the lobulated anterior mediastinal mass invading the right atrium and with significant compression of the cavo-atrial junction (green arrow).

     
    Area of Interest: Cardiac; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Axial contrast-enhanced CT image shows the lobulated anterior mediastinal mass invading the right atrium (as demarcated by green curvilinear lines).

     
    Area of Interest: Cardiac; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;
     
     
  • Figure 3
    Coronal contrast-enhanced CT images
     

    Selected coronal contrast-enhanced CT image shows a large mostly homogenously attenuating lobulated mass-like conglomeration occupying the anterior mediastinal region with invasion of the right atrium.

     
    Area of Interest: Cardiac; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;

    Selected coronal contrast enhanced CT image showing the degree of right atrial invasion as well as flattening at the cavo-atrial junction (green arrow). Only a filiform contrast tract is seen towards its inferior...

     
    Area of Interest: Cardiovascular system; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;
     
     
  • Figure 4
    Sagital contrast enhanced CT images

    Selected contrast-enhanced CT image showing a large lobulated anterior mediastinal mass-like conglomeration (demarcated by a green arrow) associatyed with encasement of great vessels.

     
    Area of Interest: Cardiac; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;
     
     
  • Figure 5
    FDG CT-PET whole body

    Selected single FDG CT-PET image shows intense avidity corresponding to the large anterior mediastinal mass. No other abnormal uptake is seen with physiological uptake noted in the urinary bladder.

     
    Area of Interest: Cardiac; Imaging Technique: PET-CT; Procedure: Diagnostic procedure; Special Focus: Haematologic diseases;
     
     
  • Figure 6
    CT guided biopsy

    Image taken during biopsy: proving large B-cell non-Hodgkin lymphoma.

     
    Area of Interest: Cardiac; Imaging Technique: CT; Procedure: Biopsy; Special Focus: Haematologic diseases;
     
     
Frontal projection showing abnormal mediastinal contours, with increased soft tissue density abutting the left hilum and right para-tracheal region (as demarcated by green curvilinear lines).
 
Lateral projection outlining added increased soft tissue density overlying the anterior mediastinal space (as demarcated by a green curvilinear line).
 
Axial contrast-enhanced CT image showing the cranial aspect of the anterior mediastinal mass (as demarcated by green curvilinear line).
 
Axial contrast-enhanced CT image showing the anterior mediastinal mass (as demarcated by green curvilinear lines).
 
Axial contrast-enhanced CT image showing the lobulated anterior mediastinal mass, encasing the great vessels (as demarcated by green curvilinear lines).
 
Axial contrast-enhanced CT image shows the lobulated anterior mediastinal mass (as demarcated by green curvilinear line).
 
Axial contrast-enhanced CT image shows the lobulated anterior mediastinal mass invading the right atrium and with significant compression of the cavo-atrial junction (green arrow).
 
Axial contrast-enhanced CT image shows the lobulated anterior mediastinal mass invading the right atrium (as demarcated by green curvilinear lines).
 
Selected coronal contrast-enhanced CT image shows a large mostly homogenously attenuating lobulated mass-like conglomeration occupying the anterior mediastinal region with invasion of the right atrium.
 
Selected coronal contrast enhanced CT image showing the degree of right atrial invasion as well as flattening at the cavo-atrial junction (green arrow). Only a filiform contrast tract is seen towards its inferior portion.
 
Selected contrast-enhanced CT image showing a large lobulated anterior mediastinal mass-like conglomeration (demarcated by a green arrow) associatyed with encasement of great vessels.
 
Selected single FDG CT-PET image shows intense avidity corresponding to the large anterior mediastinal mass. No other abnormal uptake is seen with physiological uptake noted in the urinary bladder.
 
Image taken during biopsy: proving large B-cell non-Hodgkin lymphoma.
 
 
 
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