case_images: PMC2718186_01
case_images: A-49-year-old man and teratoma and malignant transformation.. A. Contrast-enhanced CT scan indicates the presence in the mediastinum of a lobulated low attenuated mass containing a fat component (HU =-45) (white arrows) and wall calcifications. The lateral wall of the mass is focally disrupted and consolidation with the fat component in the adjacent left upper lobe is noted (arrowheads). A heterogeneously enhanced solid portion is observed in the medial aspect of the mass, and this obliterates the fat plane between the mass and the main pulmonary artery (black arrows).. B. CT scan obtained at the origin of the great vessels shows an inhomogeneously enhanced solid portion which invades the mediastinal great vessels (white arrows) and was pathologically proven to be adenocarcinoma ( right bracheocephalic artery, *left common carotid artery, *left subclavian artery).. C. Light microscopic examination demonstrates that part of the resected mass is composed of mature fat (F), chrondroid cartilage (C), and glandular tissue (arrows) (x20, Hemtoxyline-eosin stain).. D. Light microscopic examination demonstrates the medial part of the mass, in which poorly differentiated adenocarcinoma crosses the fibrous outer wall (W) (x20, Hematoxyline-eosin stain).
case_images: kjr-1-162-g001.jpg
case_images: PMC2718186_01_kjr-1-162-g001.jpg
case_images: F1
case_images: The lateral wall of the mass was focally disrupted and consolidation with the fat component in the adjacent left upper lobe was noted, thus suggesting that the tumor had ruptured (Fig. 1A). An inhomogeneously enhanced solid portion was noted in the medial aspect of the mass and extended to the upper mediastinum, obliterating the fat plane between the mass and the mediastinal vessels (Fig. 1B). Microscopically, while most of the mass was mature teratoma with hemorrhage and necrosis (Fig. 1C), the solid portion of the wall was found to be poorly differentiated adenocarcinoma (Fig. 1D).