EURORAD ESR

Case 15651

Unusual presentation of Multiple endocrine Neoplasia type 1: Primary thymic neuroendocrine tumor

Author(s)
Haesung Lee1, BS, Tarun Ramayya MD, Supriya Gupta MD, Darko Pucar MD, Nikhil Patel2 MD, Jayanth H.Keshavamurthy3 MD.

(1) Senior Medical Student, Philadelphia College of Osteopathic Medicine.
(2) MD-Assistant Professor, Department of Pathology, Augusta University.
(3) MD-Assistant Professor, Department of Radiology, Augusta University.

1120 15th street, BA-1411 30912 Augusta, United States of America;
Email:
haesungle@pcom.edu
npatel4@augusta.edu
jkeshavamurthy@augusta.edu
 
Patient
male, 60 year(s)
 
 
  • Figure 1
    Contrast enhanced CT
     

    (A) Coronal view shows heterogeneous anterior mediastinal soft tissue mass with irregular border line (dotted arrow) that is invading adjacent structures (white arrows).

     
    Area of Interest: Mediastinum; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;

    (B) Sagittal view shows anterior mediastinal mass with invasion near by structures (white arrows).

     
    Area of Interest: Mediastinum; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 2
    Contrast enhanced MRi

    T1 axial post contrast showing a heterogeneously enhancing anterior mediastinal mass with irregularly speculated borders (White arrow).

     
    Area of Interest: Mediastinum; Imaging Technique: MR; Procedure: Staging; Special Focus: Neoplasia;
     
     
  • Figure 3
    Octreotide scan

    Fused Octreotide scan showing increased radio active uptake in the anterior mediastinal mass (White dotted arrow).

     
    Area of Interest: Mediastinum; Imaging Technique: Nuclear medicine conventional; Procedure: Diagnostic procedure; Special Focus: Neoplasia;
     
     
  • Figure 4
    Pathology slides
     

    (A) Gross pathology image shows tumor size, greatest dimension 5.5 cm with additional dimensions of 5.2x3.6 cm.

     
    Area of Interest: Mediastinum; Imaging Technique: Percutaneous; Procedure: Biopsy; Special Focus: Neoplasia;

    (B) H&E stained (40X magnification) shows organoid pattern with islands, ribbons, festoons, trabeculae, rosettes of small round cells with minimal cytoplasm, salt and pepper chromatin.

     
    Area of Interest: Mediastinum; Imaging Technique: Percutaneous; Procedure: Biopsy; Special Focus: Neoplasia;

    (C) Tumor cells are diffusely positive for Synaptophysin (×400)

     
    Area of Interest: Mediastinum; Imaging Technique: Percutaneous; Procedure: Biopsy; Special Focus: Neoplasia;
     
     
(A) Coronal view shows heterogeneous anterior mediastinal soft tissue mass with irregular border line (dotted arrow) that is invading adjacent structures (white arrows).
 
(B) Sagittal view shows anterior mediastinal mass with invasion near by structures (white arrows).
 
T1 axial post contrast showing a heterogeneously enhancing anterior mediastinal mass with irregularly speculated borders (White arrow).
 
Fused Octreotide scan showing increased radio active uptake in the anterior mediastinal mass (White dotted arrow).
 
(A) Gross pathology image shows tumor size, greatest dimension 5.5 cm with additional dimensions of 5.2x3.6 cm.
 
(B) H&E stained (40X magnification) shows organoid pattern with islands, ribbons, festoons, trabeculae, rosettes of small round cells with minimal cytoplasm, salt and pepper chromatin.
 
(C) Tumor cells are diffusely positive for Synaptophysin (×400)
 
 
 
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