Ann Thorac Surg 2009;87:1960. doi:10.1016/j.athoracsur.2008.08.014
© 2009 The Society of Thoracic Surgeons
Images in Cardiothoracic Surgery
Giant Thymolipoma Involving Both Chest Cavities
Xin Jiang, MDa,
Yulin Fang, MDc,
Guifang Wang, MD, PhDb,*
a Clinical Medical College, Shanghai, China
b Department of Respiratory Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, China
c Department of Respiratory Medicine, Anqing Navy Hospital, Anqing, Anhui Province, China
* Address correspondence to Dr Wang, Department of Respiratory Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China (Email: panpan-8848{at}126.com).
A 45-year-old woman was presented to our hospital with complaints of gradually increasing breathlessness of 2 years' duration and exacerbation for 2 months. The patient had no history of cough, hemoptysis, loss of weight, loss of appetite, or other constitutional symptoms. A chest roentgenogram revealed a large mass obscuring the border of the heart and the diaphragm. This case was suspected to be exudative pleuritis in the outpatient department and she was immediately admitted to the hospital. On physical examination, the right lung field was dull to percussion with decreased breath sounds on auscultation. A chest computed tomographic scan revealed a large mass occupying the entire right hemithorax and extending anteriorly into the left hemithorax. The mass was comprised of fat density with areas of soft-tissue density in-between, which caused lung collapse and mediastinal shift. The mass was draping around the heart and great vessels (Fig 1). Malignancy could not be ruled out because of the irregularity of the tumor appearance.
An extended thymectomy was performed 2 weeks after admission. A mass connected to the thymus with a pedicle was completely removed. The tumor measured approximately 40 x 30 x 10 cm and weighed 3,980 g (Fig 2A). No regional macroscopic metastases were evident, and later anatomicopathologic examination showed a lesion composed of an admixture of mature adipose tissue and microscopically normal thymus tissue showing lymphocytes and thymic corpuscles, which are features consistent with thymolipoma (Fig 2B; hematoxylin & eosin stain, x100). The patient's postoperative course was good; at 1 year postoperatively, there was no evidence of recurrence.
