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Scan shows lobulated lesion with calcification, cystic area, thymic neoplastic lesion. Meaning?

lobulated lesion with internal small area of calcification,internal cystic area and enhancing solid component in the mediastinum in the left mid zone anteriorly in the left paramidline position involving the pericardium?thymic neoplestic lesion?malignant teratoma biopsy corrtation recommended ...sir what is this i dont undrstand
Asked On : Fri, 12 Apr 2013
Answers:  2 Views:  346
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,

Your scan report shows that there is a mass lesion in the mediastinum.
Mediastinum is the potential space between two lungs.
This lesion is lobulated (has multiple lobules), shows calcification.
Mediastinum contains thymus, lymph nodes, pericardium.

This mass can be arising from any of the mentioned organ.
A biosy which is aprocedure in which a small piece of the mass is taken with the help of a biopsy needle.
The small piece of the tissue is processed, stained and seen under a microscope.

This investigation will determine the site and character of the lesion.
After this investigation, the correct management can be pursued.
Consult your doctor at the earliest.

Thanks and take care.
Dr Shailja P Wahal
Answered: Wed, 24 Apr 2013
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Radiologist Dr. Vamshi Kotha's  Response

It appears that you are describing a CT scan of the thorax. The commonest anterior mediastinal masses include thymoma, teratoma and lymphoma.

Depending on your age and other features, a possible diagnosis can be made. Thymoma's usually occur in middle aged individuals (30-50 years) and maybe associated with Grave's disease. They are usually enhancing masses but don't often show calcification and cystic change. also, involvement of the pericardium is an ominous sign and may point towards a thymic carcinoma if thymic in origin.

Teratomas usually occur in young individuals (15-30 years) and commonly show calcificaton and cystic change. They may also invade the pericardium.

Lymphomas can occur in any age group (usually 20-40 years) and are usually seen as enhancing lobulated masses which may show cystic change. However, calcification is only common after radiotherapy.

All these lesions are worrisome and require further evaluation, most often by a CT guided biopsy and histopathological examination to make an exact diagnosis before proceeding with treatment. Biopsy just means insertion of needle under CT guidance into the mass and extracting some tissue for histopathological examination.

You need to consult an oncologist or chest surgeon at the earliest.

Answered: Wed, 24 Apr 2013
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