CHEST RADIOLOGY



Case 15:
A 13-year-old female presents with loss of weight. CT is requested after having a look at the chest radiograph.
What is the diagnosis?
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Fig 1 Fig 2(contrast)
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Fig 3(contrast) Fig 4
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Findings reveal a large necrotic rim-enhancing mass lesion in the anterior mediastinum.
A parenchymal lesion is seen in the right lung, with splenic deposits.

Diagnosis

Lymphoma.
Biopsy was suggestive of Non-Hodgkin's lymphoma (lymphoblastic type).

Discussion

There are three major types of childhood non-Hodgkin's lymphomas:
lymphoblastic lymphoma, small noncleaved cell lymphoma (either Burkitt's lymphoma or non-Burkitt's lymphoma), and large cell lymphoma.

Staging

Stage I: Cancer is found in only one area outside of the abdomen or chest.

Stage II: Any of the following mean the disease is stage II:

Cancer is found in only one area and in the lymph nodes around it.
Cancer is found in two or more lymph nodes or other areas on the same side of the diaphragm (the thin muscle under the lungs that helps you breathe).
Cancer is found to have started in the digestive tract. The lymph nodes in the area may or may not have cancer.

Stage III: Any of the following mean the disease is stage III:

Cancer is found in tumors or lymph nodes on both sides of the diaphragm.
Cancer is found to have started in the chest.
Cancer is found in many places in the abdomen.
Cancer is found in the area around the spine, around the outermost covering of the brain, or on the outermost covering of the brain (epidural tumors).

Stage IV: Cancer has spread to the bone marrow or to the brain and/or the spinal cord.




Dr. Rajesh Mayekar, Vasai