Making an accurate diagnosis of anterior mediastinal lesions: a proposal for a new diagnostic algorithm from the BTOG Thymic Malignancies Special Interest Group.

Due to the rising demand in cross-sectional thoracic imaging, anterior mediastinal lesions are being identified with increasing frequency. Following iterative and multidisciplinary discussions, the BTOG Thymic Malignancies Special Interest Group have developed an algorithm to standardise the diagnostic approach for these relatively uncommon but important conditions which span from benign (thymic remnant, thymic hyperplasia and thymic cysts) to suspected localised thymomas to suspected more aggressive malignancy (thymic carcinoma, lymphoma and germ cell tumours). For each condition, we provide a brief description, an overview of the key radiological findings and a description of the proposed algorithm including the rationale behind the recommendations. We also highlight the role of magnetic resonance (MR) imaging for the characterisation of anterior mediastinal masses in specific indications when the necessary local resources and expertise exist. In addition, we hope this provides the rationale for service development in MR of the anterior mediastinum where current resource and expertise requires development. Through this standardised pathway, we hope to drive improvements in patient care by rationalising surveillance schedules, avoiding unnecessary resections of benign entities with their associated morbidity and optimising the diagnostic work-up prior to the appropriate treatment of anterior mediastinal malignancies.

Tumor fibroso solitario intrapulmonar asociado a hemoptisis: a propósito de un caso / Intrapulmonary solitary fibrous tumor associated with hemoptysis: a case report

El tumor fibroso solitario intrapulmonar es una neoplasia mesenquimal extremadamente rara sobre la que existen muy pocas referencias en la literatura. Presentamos el caso de una mujer joven con hemoptisis que en la radiografía simple de tórax presentó una masa pulmonar, efectuándose a continuación una TCMD con contraste que mostró una tumoración pulmonar sólida, bien definida y con realce heterogéneo. Se realizó resección quirúrgica de dicha lesión y el estudio histológico reveló un tumor fibroso solitario intrapulmonar con un área de degeneración mixoide. A propósito de este caso realizamos una descripción de los hallazgos clínicos, radiológicos e histológicos de esta rara entidad, así como una revisión de la bibliografía (AU)

Intrapulmonary solitary fibrous tumor is an extremely rare mesenchymal neoplasm about which very few references can be found in the literature. We present the case of a young woman with hemoptysis in whom plain-film chest radiographs showed a pulmonary mass. Contrast-enhanced MDCT showed a solid lung tumor with well-defined margins and heterogeneous enhancement. Histological study after surgical resection of the lesion revealed an intrapulmonary solitary fibrous tumor with an area of myxoid degeneration. We describe the clinical, radiological, and histological findings for this rare entity and review the relevant literature (AU)

[Intrapulmonary solitary fibrous tumor associated with hemoptysis: a case report]. / Tumor fibroso solitario intrapulmonar asociado a hemoptisis: a propósito de un caso.

Intrapulmonary solitary fibrous tumor is an extremely rare mesenchymal neoplasm about which very few references can be found in the literature. We present the case of a young woman with hemoptysis in whom plain-film chest radiographs showed a pulmonary mass. Contrast-enhanced MDCT showed a solid lung tumor with well-defined margins and heterogeneous enhancement. Histological study after surgical resection of the lesion revealed an intrapulmonary solitary fibrous tumor with an area of myxoid degeneration. We describe the clinical, radiological, and histological findings for this rare entity and review the relevant literature.