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The diagnosis of a mediastinal germ cell tumor should be considered in all young males with a mediastinal mass. In addition to physical examination and routine laboratory studies, initial evaluation should include CT of the chest and abdomen, and determination of serum levels of HCG and alpha-fetoprotein.
The mediastinum has three main parts: the anterior mediastinum (front), the middle mediastinum, and the posterior mediastinum (back). Masses in the anterior portion of the mediastinum can include thymoma, lymphoma , pheochromocytoma , germ cell tumors including teratoma , thyroid tissue, and parathyroid lesions.
This PA chest radiograph demonstrates an abnormal contour in the right hilar region, with visualization of the pulmonary vessels through the mass (the hilar overlay sign) indicating its posterior mediastinal location. On resection this was found to be a benign solitary fibrous tumor of the pleura.
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Despite 80% PMLBCL being stage I or II, the presenting anterior mediastinal mass is often over 10 cm and is locally invasive of lung, chest wall, pleura, and pericardium. [6] At initial presentation, PMLBCL is usually confined to mediastinum, but its bulk, rather than additional adenopathy, can sometimes be palpated at the low neck. [6]
Micrograph of a primary mediastinal large B-cell lymphoma, a cause of mediastinal lymphadenopathy. H&E stain. Mediastinal lymphadenopathy or mediastinal adenopathy is an enlargement of the mediastinal lymph nodes.
Pain on the right side of the abdomen under the ribs is a common complaint. We’ve all felt it at some point. The pain may be sharp or dull. Perhaps it was sudden or slowly crept up on you.
The patient was revived on Dec. 6 and, the complaint says, Shore went in on Dec. 8, 2020, to repair the bowel perforation. Shore documented bowel changes. The patient died later that day.