Presentation
Dyspnea and weight loss.
Patient Data
Huge mediastinal soft tissue lesion measuring 12 x 16 x 15.8 cm in AP, SS and CC dimensions respectively encasing the four chambers of the heart with evident separating pericardial fat planes. It encases the ascending aorta, aortic arch, and its main branches as well as the proximal part of the descending aorta. It also encases the pulmonary artery and its main branches. It shows heterogenous texture mainly composed of nodular densities as well as multiple intervening fatty areas. It shows heterogenous post contrast enhancement.
MUltiple amalgamated right paratracheal nodes, left cardiophrenic, right axillary and cervical lymph nodes.
Normal abdominal CT scan. No abnormal abdominal lymph nodes.
Pathology from mediastinal mass revealed nodular sclerosing type, Hodgkin lymphoma
Case Discussion
This case represents mediastinal lymphoma pathologically proved nodular sclerosing Hodgkin lymphoma, presented as a huge mediastinal soft tissue mass lesion with mediastinal lymph nodes as well as cervical and right axillary lymph nodes. No abdominal involvement. Nodular sclerosing Hodgkin lymphoma is a type of primary mediastinal lymphomas. Approximately 60% of all Hodgkin lymphoma involves the mediastinum at presentation.
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