Chest tomography has played an essential role during the coronavirus disease 2019 (COVID-19) pandemic since it has allowed to suspect and diagnose the disease early and to assess the severity of lung involvement, predict the disease's course, and detect the complications associated with it. Certain chest CT findings have been reported in more than 70% of reverse transcription polymerase chain reaction (RT-PCR) test-proven COVID-19 cases, including ground-glass opacities, vascular enlargement, bilateral abnormalities, lower lobe involvement, and posterior predilection. In COVID-19-endemic regions, observing these chest CT findings should raise the suspicion of a possible COVID-19 diagnosis. Rare reported CT findings in RT-PCR test-proven COVID-19 cases include pleural effusion, lymphadenopathy, tree-in-bud sign, central lesion distribution, pericardial effusion, and cavitating lung lesions. The observation of one or more of these findings suggests an alternative diagnosis, although COVID-19 cannot be excluded from the differential diagnosis. Here, we report an interesting case of a patient with no relevant history presenting a COVID-19 infection which, as a complication, presented cystic lesions; we discuss its etiology briefly.
A hibernoma is an uncommon benign soft tissue tumor composed of brown adipose cells; the mediastinal location as presentation is scarce, with only six cases previously reported. The diagnosis of hibernoma is challenging and must be made based on the clinical, radiographic, and cytologic features. Here we present a 33-year-old woman without any relevant medical history presented for outpatient evaluation of a dry cough persisting for three months, and the X-rays revealed a dense well-defined mass with smooth borders in the left upper posterior mediastinum. Posterior mediastinal lesions represent a relatively small proportion of patient loads in thoracic surgery and account for a total of 25% of the cases, with neurogenic tumors among the most frequently seen in adults. Of these, the nerve sheath tumors (schwannoma, neurofibroma, paraspinal ganglioneuroma) are the most seen. Other differential diagnoses of paravertebral masses are the paraspinal abscess, metastases, hematoma, descending aortic aneurysm, among others. The patient underwent surgical resection via left posterolateral thoracotomy, without complications.
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