Huge complex mediastinal mass presenting as a rare variant of lymphoblastic leukemia/lymphoma.

  • Hira Pervez DUHS.
  • Salwa Pervez DUHS.
  • Soomro Niaz DUHS.
  • Saima Imam DUHS.
Keywords: Anterior Mediastinal Mass, Mediastinum, Non-Hodgkins Lymphoma, Respiratory Compromise

Abstract

The mediastinum is the space that separates the lungs from the rest of the chest. The most common mediastinal masses are neurogenic tumors (20% of mediastinal tumors), followed by thymoma (15-20%). Other masses include lymphoma, pheochromocytoma, germ cell tumors, including teratoma, thyroid tissue, and parathyroid lesions. Lymphoblastic leukemias/lymphomas are neoplasms of precursor T cells and B cells also known lymphoblasts. World Health Organization (WHO) classification has unified these entities as precursor B-cell and T-cell lymphoblastic leukemia/lymphoma. We present here a rare variant of non-Hodgkins lymphoma in a 12-year-old female who complained of worsening dyspnea and lower left-sided chest pain. The patient was empirically treated with anti-tuberculous drugs without relief. On admission, a CT scan chest showed an anterior mediastinal mass approximately 25x12.5 cm adherent to the mediastinal structures. Resection of the mass was done sparing the phrenic nerve. The sample was sent for histopathology which suggested small cells with hyperchromatic nuclei and positive tumor markers. Rare occurrence of this ailment can lead to mistakes with the diagnosis.  Therefore the uniqueness of our case lies in the fact that a T-LBL can present with such a huge mass.

Author Biographies

Hira Pervez, DUHS.

MBBS

Post Graduate Trainee Thoracic Surgery

 

Salwa Pervez, DUHS.

MBBS

House Surgeon Thoracic Surgery

 

Soomro Niaz, DUHS.

MBBS, FCPS

Associate Professor Thoracic Surgery

 

Saima Imam, DUHS.

MBBS, MCPS

Consultant Anesthetist Thoracic Surgery

 

Published
2020-10-10