• Mediastinal neoplasms
• thymus
• hyperplasia
• imaging/CT MRI etc
• paediatric physician

A 2-year-old boy presented with fever, dry cough and dyspnoea for 3 days. Breath sounds were absent and thoracic percussion revealed dullness in the lower two-thirds of the left hemithorax. A chest x-ray showed almost complete opacification of these areas (figure 1). The boy was successfully treated with antibiotics for lower airways infection but tachypnoea persisted and the x-ray showed no change after 6 weeks. A CT scan was performed and showed a heterogeneous mass in the anterior mediastinum, predominantly on the left side, occupying most of the left hemithorax. This lesion showed areas of lower attenuation interspersed with areas of soft tissue attenuation (figure 2). The possibility of …