Background : Mediastinal teratoma and other mediastinal tumors are very challenging to be distinguished from other mediastinal tumors. Mediastinal tumors can be optimally evaluated with computed tomography (CT). In this paper we present three young male patients with similar symptom of chronic chest pain and chronic cough. Materials and Methods: Conducting a literature review and medical records. Results : All patients in this case are young age male, below two decades. All chest CT shows giant mass, but they have different enhancing pattern, different amount of solid, cystic, calcification component. To make correct diagnosis of the mediastinal mass is important because of treatment planning difference, surgery or chemoteraphy. The first case shows benign teratoma with characteristic of heterogenous mass with large amount of fat, with presence of solid and calcification component. The second case shows malignant germ cell tumor with feature of heterogenous mass with predominantly solid component and small amount of fat. It also shows metastatic process in lung and bone. The third case shows Hodgkin lymphoma with slight enhanced mass that narrowed pulmonary artery and caused pericardial effusion. Conclusion: Various features of mediatinal tumors can be distinguished with CT modality.

Aspergilloma is a mass-like fungus ball consisting of Aspergillus fumigatus. Aspergilloma occurs in patients with pulmonary structural abnormalities in which the presence of a previous cavity is the predisposing factor that most often results in Aspergillus colonization, especially in tuberculosis endemic countries. 28 y.o and  33 y.o female , complained of hemoptysis, chest pain, weight loss, and a history of TB treatment. The chest X-ray and CT scan revealed a solid lesion with an “Air-crescent sign” indicating Aspergilloma lesion. Patients were given symptomatic, anti-fungal drugs, and supported  by embolization procedure to reduce hemoptysis. The patient's condition began to improve after treatment. Imaging findings in x-rays and CT scans that point to Aspergilloma will help doctors in further management to provide a better prognosis for the patient.

An abnormal free gas collection in the thorax and abdomen is a condition which is present of abnormal air in the thorax and abdominal cavity that normally not found. Radiological examination plays very important role to detect the presence of abnormal gas, the volume, the location, and the complication. Some of these conditions can represent classic radiological appearance that we can find in everyday practice.

Thymoma is a rare malignancy with an incidence of 0,15 case per 100.000 population and is the most commonly diagnosed anterior mediastinal malignancy. With 12,5% 15-year survival rate, and is often accompanied by autoimmune disease such as myasthenia gravis, pure red blood cell aplasia, and hypogammaglobulinemia, better understanding of factors affecting prognosis is needed to improve patient quality of life and survival.

Background: Leptomeningeal disease occurs in 3-5% of patients with lung cancer, mainly adenocarcinoma subtype. Adenocarcinoma is the most common histological finding in Asian women. Case: A 51-year-old woman with right-sided bronchogenic adenocarcinoma T4N3M1c Std IVB mutation(+) developed decreased vision, severe bilateral sensorineural deafness and psychiatric disorders after receiving Gefitinib 15 months. There was no evidence of brain metastasis from brain MRI. From evaluation of chest CT-scan, we found the disease was progressive and no Mutation Detected from ctDNA, so Gefitinib was discontinued. Conclusion: We found some difficulties in evaluating side effects of therapy and disease progression due to patient's condition in the form of decreased total vision, severe sensorineural deafness, and psychiatric disorders. However, because no radiological evidence of brain metastases was found, we suspect this patient suffered from leptomeningeal disease. Keywords: Lung Cancer, Adenocarcinoma, Gefitinib, Leptomeningeal Disease