A case of cholesterol granuloma in the thymus

Kawai, T; Uehara, H; Matsutani, Noriyuki; Saito, Koji; Ishida, Toru; Kawamura, Masafumi

doi:10.2995/jacsurg.31.58

Cited by 5 publications

(2 citation statements)

References 10 publications

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“…The preoperative diagnosis of mediastinal cholesterol granuloma may be challenging due to its rarity and radiological appearances resembling common mediastinal tumors such as thymoma. In some reports, the lesions had low-density areas equivalent to fat tissue, scattered nodules, and spotty calcifications on chest CT images [6,9]. Positron emission tomography shows an increased glucose uptake, probably related to the granulomatous inflammation.…”

Section: Discussionmentioning

confidence: 96%

“…Our search of the literature revealed 12 cases of cholesterol granulomas occurring in the mediastinum, including the present case. The patients were 10 men and 2 women, ranging in age from 25 to 75 years old with a mean age of 61.8 years old [1,2,[5][6][7][8][9][10][11][12] (Table 1). The clinical presentations were variable, and some of the cases were encountered incidentally, such as the present case.…”

Section: Discussionmentioning

confidence: 99%

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Multifocal cholesterol granulomas of the anterior mediastinum

2020

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Background: Cholesterol granuloma in the mediastinum is rarely observed, accounting for 1% of all mediastinum tumors. There have been only a few reports of multifocal cholesterol granulomas of the thymus. We herein report a rare case of multifocal cholesterol granuloma in the thymus that was incidentally detected during follow-up of an aortic aneurysm. Case presentation: The patient was a 70-year-old man with dyslipidemia and hypertension who was referred to our hospital to undergo an operation for chest aortic aneurysm. Preoperative computed tomography (CT) showed 4 lesions in the anterior mediastinum measuring up to 4 cm in size with slight contrast enhancement and spotty calcification. Therefore, a thymoma, bronchogenic cyst, or lymphangioma were considered as the preoperative diagnosis. The patient underwent total thymectomy under thoracotomy followed by aortic arch replacement for the aortic aneurysm. The pathological diagnosis was multifocal cholesterol granulomas in the thymus. Conclusions: Cholesterol granulomas should be included in the differential diagnosis of cystic tumor in the mediastinum, especially in patients with basal disease such as dyslipidemia and hypertension, which may lead to aortic aneurysm. Furthermore, complete surgical resection and a detailed histological evaluation are important for the accurate diagnosis and treatment.

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Section: Discussionmentioning

confidence: 96%