CTICasesPoorly Differentiated Thymic Carcinoma with Neuroendocrine Differentiation and Pleural Drop Metastases
Imaging findings
Frontal and lateral chest radiographs show a large anterior mediastinal mass and a subtle, small, oval-shaped pleural opacity along the right major fissure. Computed tomography and sagittal reconstructions confirm a large anterior mediastinal tumor associated with pleural-based metastases located along the pleural membranes and at the junction of the minor and major fissures.
Key takeaways
Thymic carcinoma with neuroendocrine differentiation can present with extensive pleural drop metastases along the fissure and pleural surfaces at the time of diagnosis, mimicking thymoma. Pathologic differentiation from thymoma is aided by immunohistochemical markers, such as the absence of immature lymphocytes in thymic carcinoma.
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