Presentation
Incidental finding
Patient Data
There is a well defined, smoothly marginated opaque lesion seen occupying the right cardiophrenic angle, the lesion has obtuse angle with the lung parenchyma and the lower lobe vessels can be traced passing through the lesion giving the hilum overlay sign, indicating a mediastinal origin.
There is a rounded, encapsulated, homogenously enhancing soft tissue lesion seen in the right anterior mediastinum, there is no associated calcification, no fat component of central necrosis.
No evidence of pleural, vascular or pericardial invasion.
No lung parenchymal pathology.
Splenomegaly and small hiatal hernia noted.
Thymoma
Case Discussion
Thymoma is the most common primary malignancy of the anterior mediastinum, it is slowly growing and can be found incidentally if no local invasion or compressive symptoms occur.
As seen with this patient, the CXR resembles a cardiac enlargement and he was asymptomatic.
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