case_images: PMC10237245_01
case_images: Chest radiographs PA (a) and lateral (b) views show a large anterior mediastinal mass lesion.
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case_images: F1
case_images: Her vital signs, blood exam, and electrocardiogram (EKG) were normal while chest radiographs revealed a large anterior mediastinal mass lesion (Figure 1).
case_images: Post-contrast chest CT scan axial (a) and coronal (b) views: A large heterogeneous enhancing anterior mediastinal mass with intrinsic necrosis.
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case_images: F2
case_images: On chest and abdominal computed tomography (CT), a large heterogeneous anterior mediastinal mass with intrinsic necrosis and indistinct tissue planes was shown (Figure 2).
case_images: Chest CT scan, lung window, axial (a) and coronal (b) views: Multiple ground glass nodules at the bilateral lungs with peribronchovascular and subpleural distribution. Post-contrast chest CT scan (c): Enlarged lymph nodes at bilateral clavicular fossa (arrows).
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case_images: F3
case_images: Multiple small nodules with indistinct outline at the bilateral lungs; lymphadenopathy at bilateral supraclavicular, paratracheal, and aortopulmonary window regions; and a small amount of pericardial effusion were also noted (Figure 3).
case_images: Contrast-enhanced abdominal CT scan axial (a) and coronal (b) views: Poor enhancing mass lesion at the body of pancreas with encasement of the superior mesenteric vein.
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case_images: F4
case_images: In addition, diffuse poor enhancing infiltrating mass lesion at the pancreas which encased the superior mesenteric vein was noted, but this did not cause occlusion nor dilatation of pancreatic duct or biliary tree (Figure 4).
case_images: Contrast-enhanced abdominal CT scan axial (a) and coronal (b) views of the kidneys: Multiple poor enhancing low attenuation lesions in the bilateral kidneys.
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case_images: F5
case_images: Multiple low-attenuation lesions in the bilateral kidneys were found (Figure 5).
case_images: Contrast-enhanced brain MRI: Homogeneous enhancing lesions in the left periventricular region (arrow in c) and septum pellucidum (arrow in d) with isointense on T1WI (a) and hyperintense on T2WI (b).
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case_images: F6
case_images: T1 weighted image (T1WI) and hyperintense on T2 weighted image (T2WI) (Figure 6). The enhanced
case_images: Pre- and post-contrast MRI: Enhancing lesions with hypointense on T1WI and iso/hyperintense on T2WI were noted at T3 and L2 vertebral bodies (arrows).
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case_images: F7
case_images: T1WI and iso/hyperintense on T2WI, involving the vertebral bodies, lamina, and pedicles of T3 and L2. Multiple abnormal enhancing spinal cord lesions with isointense signal on T1WI and iso-/hyperintense with surrounding edema on T2WI were also noted (Figures 7 and 8). These features in the spine and brain were compatible with lymphoma.
case_images: Pre- and post-contrast MRI: Multiple enhancing spinal cord lesions with isointense on T1WI and iso/hyperintense on T2WI (arrows).
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case_images: F8
case_images: T1WI and iso/hyperintense on T2WI, involving the vertebral bodies, lamina, and pedicles of T3 and L2. Multiple abnormal enhancing spinal cord lesions with isointense signal on T1WI and iso-/hyperintense with surrounding edema on T2WI were also noted (Figures 7 and 8). These features in the spine and brain were compatible with lymphoma.