Department of Hematology-Oncology, Chongqing University Cancer Hospital, No.181 HanYu Road, Chongqing, 400030, China.
Department of Nuclear Medicine, Chongqing University Cancer Hospital, Chongqing, 400030, China.
BMC Pulm Med. 2024 Jun 14;24(1):280. doi: 10.1186/s12890-024-03090-x.
The diagnostic complexities that arise in radiographic distinction between ectopic pleural thymoma and other thoracic neoplasms are substantial, with instances of co-occurring T-cell lymphocytosis and osseous metastasis being exceedingly rare.
A 51-year-old woman was admitted to our hospital with dyspnea and chest pain. Upon imaging examination, she was found to have diffuse and nodular pleural thickening on the left side, collapse of the left lung and a compression in the second thoracic vertebrae. All lesions showed significant F-FDG uptake on F-FDG PET/CT examination. Furthermore, she exhibited T-cell lymphocytosis in her peripheral blood, lymph nodes, and bone marrow. After ruling out malignant pleural mesothelioma (MPM), lung cancer with pleural metastasis, and T-cell lymphoma, the definitive diagnosis asserted was ectopic pleural thymoma with T-cell lymphocytosis and bone metastasis.
Physicians need to expand their knowledge of the imaging features of ectopic pleural thymoma. Cases with T-cell lymphocytosis may exhibit increased aggressiveness and prone to bone metastasis.
在影像学上区分胸壁胸腺肿瘤和其他胸部肿瘤时，存在许多诊断复杂性，同时存在 T 细胞淋巴细胞增多和骨转移的情况极为罕见。
一名 51 岁女性因呼吸困难和胸痛就诊于我院。影像学检查发现左侧弥漫性和结节性胸膜增厚，左肺塌陷，第二胸椎受压。所有病变在 F-FDG PET/CT 检查中均显示明显的 F-FDG 摄取。此外，她的外周血、淋巴结和骨髓均出现 T 细胞淋巴细胞增多。在排除恶性胸膜间皮瘤（MPM）、肺癌伴胸膜转移和 T 细胞淋巴瘤后，明确诊断为胸壁胸腺肿瘤伴 T 细胞淋巴细胞增多和骨转移。
医生需要扩大对胸壁胸腺肿瘤影像学特征的认识。伴有 T 细胞淋巴细胞增多的病例可能表现出更高的侵袭性，且易发生骨转移。
