Three in one: A case presented with multiloculated thymic cyst, thymic Hodgkin lymphoma and pericardial cyst

Kocaman, Gökhan; Özakıncı, Hilal; Yüksel, Seher; Çoruh, Ayşegül Gürsoy; Yenigün, Mustafa; Yüksel, Meltem Kurt; Enön, Serkan

doi:10.5606/tgkdc.dergisi.2023.22064

Turk Gogus Kalp Dama

2023

DOI: 10.5606/tgkdc.dergisi.2023.22064

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Three in one: A case presented with multiloculated thymic cyst, thymic Hodgkin lymphoma and pericardial cyst

Gökhan Kocaman

Hilal Özakıncı

Seher Yüksel

et al.

Abstract: Multiloculated thymic cyst is a cystic reaction of medullary epithelium to inflammatory process. In most cases, the exact cause of the inflammation is not known. Hodgkin lymphoma and multiloculated thymic cyst coexistence is a rare condition and may cause significant diagnostic difficulties. Herein, we present a rare case who underwent surgery for multiloculated thymic cyst and was subsequently diagnosed with Hodgkin lymphoma and had a concurrent pericardial cyst.

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Cited by 2 publications

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The Cystic Appearance of a Mediastinal Mass Does Not Exclude Lymphoma: A Case Example of Classic Hodgkin Lymphoma in a Thymic Cyst and a Brief Literature Review

Kahwash,

Chaves,

Patton

2024

Ibnosina Journal of Medicine and Biomedical Sciences

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Herein, we report a case of a 16-year-old girl who presented with an episode of shortness of breath while playing sports. Upon radiologic workup, she was found to have a large multicystic anterior mediastinal mass. The cystic appearance of mass and lack of constitutional symptoms contributed to favoring a benign cystic process and deferring surgical resection until the end of sport season. When surgery was performed 3 months later, microscopic examination showed findings diagnostic of classic Hodgkin lymphoma arising in a thymic cyst. Despite the rarity of such cases, it is important to remember that the cystic nature of an anterior mediastinal mass does not exclude lymphoma. Definitive diagnosis is not possible without examination of representative tissue.

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The Cystic Appearance of a Mediastinal Mass Does Not Exclude Lymphoma: A Case Example of Classic Hodgkin Lymphoma in a Thymic Cyst and a Brief Literature Review

Kahwash,

Chaves,

Patton

2024

Ibnosina Journal of Medicine and Biomedical Sciences

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Anterior mediastinal masses and thymic cysts

Özdemir

2025

World J Clin Cases

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Cystic lesions of the anterior mediastinum in children suggest a well-known group of benign lesions that are comparatively frequent. Thymic cysts (TCs) are mostly positioned in the anterior mediastinum and some patients in the neck. Benign TCs classified as congenital intra-thoracic mesothelial cysts are commonly asymptomatic and have slight clinical significance. Multilocular TC, which can mimic another anterior mediastinal cystic tumor and is seen in adults, is more clinically important. It is a sporadic mediastinal lesion thought to arise in the course of acquired inflammation. Congenital mediastinal cysts represent 3%-6% of all mediastinal tumors and 10%-18% of radiologically reported mediastinal masses. Mediastinal TCs are uncommon and it is hard to know their true incidence. About 60% of cases with mediastinal TCs are asymptomatic, and the remainder of patients complains of nonspecific symptoms (e.g., chest pain, dyspnea, or cough). The literature suggests that most cysts are benign, but an indefinite percentage may have a neoplastic process and result in significant compressive symptoms over time. Clinical symptoms of TCs vary depending on the location. In addition, frequent symptoms at the appearance of enlarged benign thymic and mediastinal cysts generally contain compressive symptoms (e.g. , respiratory distress, thymic pain, and symptoms related to Horner syndrome, hoarseness, dysphonia, dyspnea, orthopnea, wheezing, and fever). Many TCs have cystic density and a neat border and are simple to diagnose with radiological imaging. However, some TCs are hard to identify before surgery and may be misidentified as thymomas depending on their site and computed tomography results. Excision by thoracotomy, median sternotomy, or video-assisted techniques is essential for conclusive diagnosis, management, and abolition of relapse of anterior mediastinal masses and TCs. Histopathologic examination may be required after surgery. Considering the extent of the mass and the preliminary inability to make a definitive diagnosis, en bloc excision of the cyst was thought to be preferred to circumvent likely complications (e.g., perforation, spillage of the contents, or incomplete excision).

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Three in one: A case presented with multiloculated thymic cyst, thymic Hodgkin lymphoma and pericardial cyst

Cited by 2 publications

References 16 publications

The Cystic Appearance of a Mediastinal Mass Does Not Exclude Lymphoma: A Case Example of Classic Hodgkin Lymphoma in a Thymic Cyst and a Brief Literature Review

The Cystic Appearance of a Mediastinal Mass Does Not Exclude Lymphoma: A Case Example of Classic Hodgkin Lymphoma in a Thymic Cyst and a Brief Literature Review

Anterior mediastinal masses and thymic cysts

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