Shah Farhan A, Greene Nelson, Purut Cemil
Internal Medicine, Lewis Gale Medical Center, Salem, USA.
Pulmonary and Critical Care, Lewis Gale Medical Center, Salem, USA.
Cureus. 2021 Jan 25;13(1):e12901. doi: 10.7759/cureus.12901.
We present a unique case of a satellite pleural-based thymoma. The patient is a 66-year-old Caucasian female with a history of a left pericardial soft tissue mass. She had been asymptomatic. Chest radiograph incidentally revealed an acute increase in the size of the mass. CT scan identified a 5.6 X 5.2 X 4.2 cm mediastinal mass in the left infrahilar region along the left lateral pericardium. Positron emission tomography (PET) scan showed the mass had an increased F18 FDG uptake with standardized uptake value (SUV) of 7.2. Left thoracotomy resected a 81g, 6 X 5.5 X 5.0 cm tan-pink well-encapsulated pedunculated mass displacing the left phrenic nerve. The mass was under the parietal pleura and not attached to the pericardium. Immunohistochemical profile identified the tumor as a thymoma, B1 type. Thymomas are relatively rare in the United States, pleural-based thymomas even more so. Early detection of thymomas is critical to avoid late-stage growths. Pericardial involvement of thymomas increases risk of pericardial effusion, tamponade and a complicated thymectomy. Pleural-based thymomas can result in diaphragmatic paralysis secondary to phrenic nerve involvement.
我们报告一例罕见的胸膜型胸腺瘤病例。患者为66岁的白种女性，有左侧心包软组织肿块病史。她之前并无症状。胸部X光片偶然发现肿块大小急剧增加。CT扫描在左肺门下部区域沿左侧心包发现一个5.6×5.2×4.2cm的纵隔肿块。正电子发射断层扫描（PET）显示该肿块F18 FDG摄取增加，标准化摄取值（SUV）为7.2。左胸切开术切除了一个81g、6×5.5×5.0cm的棕粉色、包膜完整的带蒂肿块，该肿块推移了左侧膈神经。肿块位于壁层胸膜下方，未附着于心包。免疫组织化学分析确定该肿瘤为B1型胸腺瘤。胸腺瘤在美国相对少见，胸膜型胸腺瘤更为罕见。胸腺瘤的早期发现对于避免晚期生长至关重要。胸腺瘤侵犯心包会增加心包积液、心脏压塞和复杂胸腺切除术的风险。胸膜型胸腺瘤可导致因膈神经受累继发的膈肌麻痹。
