Clinical Presentation
Fatigue, anemia, petechiae, and easy bruising in a 24-year-old man.
Imaging Findings
(A–C) Contrast-enhanced computed tomography of the chest shows a large mediastinal mass diffusely infiltrating the different compartments of the mediastinum (black arrows). Pericardial involvement (white arrows) as well as bilateral pleural fluid collections are also noted.
Differential Diagnosis
• Leukemia (acute lymphocytic leukemia [ALL]): Abnormally enlarged mediastinal lymph nodes or diff use mediastinal masses are commonly seen in acute and chronic leukemias.
• Lymphoma: Both Hodgkin and non-Hodgkin lymphomas may present with extensive mediastinal involvement, as well as pleural and pericardial effusion.
• Small-cell lung cancer:
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