Imaging Sciences Interesting Cases
Case 199
Nadia F. Yusaf, MD
Clinical Presentation: A 17-year-old female presented with abdominal pain.
Imaging Findings: Mediastinal widening/ anterior mediastinal mass.
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| Figure 1. PA view of the chest. |
Diagnosis: Hodgkin lymphoma, nodular sclerosing type
Discussion: On imaging, there is a predilection for the anterior mediastinum. Nodes rarely calcify prior to treatment. CT is the modality of choice for initial staging and follow-up monitoring of Hodgkin disease (HD). Other anterior mediastinal masses include thymoma, thyroid masses, teratoma and germ cell tumors. The Reed-Sternberg cell is pathoneumonic. Clinically, the patient may present with asymptomatic cervical or supraclavicular lymphadenopathy. There is a bimodal distribution of disease (3rd to 8th decade of life). Chemotherapy and radiation have a 90% cure rate.
References:
- Dessain SK, Spears JL, Argiris A. Hodgkin disease. eMedicine, Oct. 31, 2008. http://emedicine.medscape.com/article/201886-overview