A 63-year-old non-Indigenous Australian woman was referred for colonoscopy and gastroenterologist opinion for a 2-month history of increasing constipation and abdominal pain, without change in dietary habits or systemic features, such as fever or weight loss.
We report the case of a 68-year-old male with a background history of smoking, who presented with left sided abdominal pain. A CT scan of abdomen was performed which showed a small 6mm pulmonary nodule in right lower lobe. A subsequent CT chest performed 4 months after the index CT scan showed no change in the size of previous nodule but an additional 5 mm nodule, multiple calcified and non-calcified pleural plaques (presumably related to work in construction industry in 1970s) and more significantly a 35 mm well circumscribed solid mass in anterior mediastinum with no invasion into adjacent structures. There was no past history of any malignancy. The clinic/radiological differential diagnosis was thymic tumour, lymphoma or a metastatic malignancy. The core biopsy showed features of a thymoma and the histology and immunophenotype of subsequent resection specimen confirmed the tumour to be a micronodular thymoma with lymphoid stroma. Micronodular thymoma with lymphoid stroma is a very rare subtype of thymoma, accounting for about 1% of all cases. The tumour is usually diagnosed as stage I/II disease. There have been no reports of recurrences, distant metastases or tumour related deaths.
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