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Virtual Pediatric Hospital: Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease: Case 42 Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease

Case 42

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Chief Complaint:
Six year old male with cough and fever

Clinical History:
At the age of two years this male patient had a cough and fever. A chest film taken at that time to rule out pneumonia (not provided) showed infiltrate and a right mediastinal fullness which was felt to represent thymus. The patient now presents at the age of six again with cough and fever.

Clinical Physical Exam:
Febrile

Clinical Labs:
Non-contributory

Clinical Differential Diagnosis:
Pneumonia

Imaging Findings:
A chest film showed a mediastinal mass. A barium swallow (not provided) showed minor displacement of the esophagus to the left. A chest CT exam showed the mass to be in the posterior mediastinum and to be of fatty density.

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Imaging Differential Diagnosis:
Lipoma

Operative Findings:
The patient underwent elective removal of the mass.

Pathological Findings:
Pathological examination showed the mass to consist mainly of mature lipocytes, as there were a few lipoblasts and little fibrous tissue.

Final Diagnosis:
Lipoma, Posterior Mediastinal

Follow-up and Prognosis:
The patient had an uncomplicated post-operative course.

Similar Cases:
Case 32, Case 35, Case 36, Case 42, Case 70

References:
None

 

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