Difficult case of mediastinal malignant lymphoma for differentiation of preoperative diagnosis

Abstract

We report a case was 24-year-old woman with a mediastinal mass shown on chest X-ray film. Chest CT revealed an anterior mediastinal tumor . A percutaneous biopsy was attempted, but no diagnosis was made. We suspected invasive thymoma, and an operation was performed. An extended thymothymectomy, partial resection of the pericardium and a left upper lobectomy were performed. Pathological findings were compatible to nodular sclerosing type Hodgkin's disease. Chemotherapy was performed after the operation and no recurrence appeared. This is a rare case of Hodgkin's disease in a mediastinal malignant lymphoma in Japan. It is important to differentiate of invasive thymomas from malignant lymphomas before operating. We reported a case of a difficult preoperative diagnosis .