Gatof Emily Stern, Jassim Sarmad H, Ahn Leah, Chen Zsu-Zsu, VanderLaan Paul A, Rangachari Deepa
Division of Medical Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Department of Pathology, Beaumont Hospital, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan.
JTO Clin Res Rep. 2023 Jan 20;4(2):100463. doi: 10.1016/j.jtocrr.2023.100463. eCollection 2023 Feb.
A 34-year-old woman presenting with abdominal pain, chest pressure, weight loss, and tachycardia was found to have an 11.4-cm anterior mediastinal mass associated with intrathoracic lymphadenopathy on chest computed tomography (Fig. 1). Core needle biopsy was concerning for a type B1 thymoma. During this patient's initial workup, she was found to have both clinical and laboratory evidence of Graves' thyroiditis, raising diagnostic suspicion for thymic hyperplasia rather than thymoma. The case discussed here highlights the unique challenges that arise in the evaluation and management of thymic masses and serves as a prudent reminder that both benign and malignant disorders may present with mass-like changes.
一名34岁女性,出现腹痛、胸部压迫感、体重减轻和心动过速症状,胸部计算机断层扫描发现前纵隔有一个11.4厘米的肿块,并伴有胸内淋巴结肿大(图1)。粗针活检结果提示为B1型胸腺瘤。在该患者的初步检查过程中,发现她同时有格雷夫斯甲状腺炎的临床和实验室证据,这增加了对胸腺增生而非胸腺瘤的诊断怀疑。本文讨论的病例突出了胸腺肿块评估和管理中出现的独特挑战,并谨慎提醒我们,良性和恶性疾病都可能表现为肿块样改变。