TY - JOUR
T1 - Deep Benign Fibrous Histiocytoma of the Anterior Mediastinum Mimicking Malignancy
AU - Puopolo, Angelica
AU - Newmarch, William
AU - Casserly, Brian
N1 - Publisher Copyright:
© 2017, Springer Science+Business Media New York.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - The following report describes the case of a 43-year-old male smoker that was referred to the rapid access lung clinic with haemoptysis, chest pain, and axillary lymphadenopathy—a clinical picture that raised concern for a possible underlying malignancy. Preliminary investigations revealed elevated D-dimers, low-volume haemoptysis, and a normal chest X-ray, which lowered the index of suspicion. However, computed tomography (CT) pulmonary angiogram identified a right hilar mass, several parenchymal cysts, and a large mediastinal mass. In addition, a left-sided adrenal lesion was also discovered following CT abdomen pelvis, potentially indicating metastatic disease. Fortunately, a positron emission tomography scan failed to detect any metabolic activity in either the right hilar mass, left adrenal lesion or the anterior mediastinal mass. CT-guided biopsy identified the mediastinal mass as a low-grade spindle cell tumour. Due to its large size, the mass was surgically resected and confirmed to be a deep benign fibrous histiocytoma. The significance of this report is to highlight a clinical presentation suggestive of malignancy but actually resulting from a rare variant of a benign tumour. The constellation of regional lymphadenopathy, respiratory and gastrointestinal symptoms, lung cysts, an adrenal tumour, and a mediastinal mass appeared to suggest a progressive disease pattern more commonly associated with malignancy.
AB - The following report describes the case of a 43-year-old male smoker that was referred to the rapid access lung clinic with haemoptysis, chest pain, and axillary lymphadenopathy—a clinical picture that raised concern for a possible underlying malignancy. Preliminary investigations revealed elevated D-dimers, low-volume haemoptysis, and a normal chest X-ray, which lowered the index of suspicion. However, computed tomography (CT) pulmonary angiogram identified a right hilar mass, several parenchymal cysts, and a large mediastinal mass. In addition, a left-sided adrenal lesion was also discovered following CT abdomen pelvis, potentially indicating metastatic disease. Fortunately, a positron emission tomography scan failed to detect any metabolic activity in either the right hilar mass, left adrenal lesion or the anterior mediastinal mass. CT-guided biopsy identified the mediastinal mass as a low-grade spindle cell tumour. Due to its large size, the mass was surgically resected and confirmed to be a deep benign fibrous histiocytoma. The significance of this report is to highlight a clinical presentation suggestive of malignancy but actually resulting from a rare variant of a benign tumour. The constellation of regional lymphadenopathy, respiratory and gastrointestinal symptoms, lung cysts, an adrenal tumour, and a mediastinal mass appeared to suggest a progressive disease pattern more commonly associated with malignancy.
KW - Anterior mediastinum
KW - Benign fibrous histiocytoma
KW - Haemoptysis
KW - Malignancy
UR - http://www.scopus.com/inward/record.url?scp=85018674986&partnerID=8YFLogxK
U2 - 10.1007/s00408-017-0013-6
DO - 10.1007/s00408-017-0013-6
M3 - Article
C2 - 28497381
AN - SCOPUS:85018674986
SN - 0341-2040
VL - 195
SP - 503
EP - 506
JO - Lung
JF - Lung
IS - 4
ER -