Case of the Week: April 26-May 3, 2012

Teenager with hypertension

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Case Details

Study shows considerable replacement of the thymus with adipose tissue. The lesion is large forming a mediastinal mass.

Answer

Diagnosis: Thymolipoma

A thymolipoma is an unusual benign mediastinal tumor, representing 5% of thymic neoplasms.

It occurs throughout life, average age of 22 years.

It usually is asymptomatic but can compress adjacent structures and can result in shortness of breath, chest pain or cough in up to 25% of patients.

It is composed of adipose tissue mixed with thymic tissue on histology and on imaging may be purely fat or mixed with soft tissue of thymic density or signal.

These lesions may be quite small or very large.

If asymptomatic, no treatment is needed.

The only therapy in symptomatic patients is removal.

These lesions are associated with myasthenia gravis, aplastic anemia, hypogamma-globulinemia, Hodgkin’s disease and chronic lymphocytic leukemia.

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