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Massive thymoma mimicking a pleural mass
  1. Stefano Palazzo1,
  2. Zaid Rahman2,
  3. Federico Femia3,
  4. Karen Harrison-Phipps3,
  5. Thomas Simpson2
  1. 1 Respiratory Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
  2. 2 Lewisham and Greenwich NHS Trust, London, UK
  3. 3 Thoracic Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
  1. Correspondence to Dr Stefano Palazzo, Respiratory Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK; s.palazzo{at}

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A 37-year-old man presented with months of weight loss, dysphagia and fatigue. He was an infrequent smoker, had no medical history and did not take regular medications. Endoscopy revealed gastro-oesophageal reflux only. Two months later, he presented with persistent cough and chest-X-ray (figure 1) revealed a large right-sided opacity.

Figure 1

Radiological appearances of the massive thymoma, showing plain chest X-ray, coronal CT and sagittal CT images.

Subsequent CT scan (figure 1) revealed a 165×122×128 mm mass in the right hemithorax, appearing to arise from the pleura, with compressive atelectasis of the lung. The diaphragm was intact, but the mass compressed the right atrium and superior vena cava (SVC).

He subsequently developed chest pains—blood tests were unremarkable, with no pulmonary embolus (PE) on CT …

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  • Contributors TS was responsible for conceiving the original idea for the manuscript. SP was responsible for initial drafting of the manuscript and collation of amendments. SP, ZR, FF, KH-P and TS were responsible for subsequent manuscript development and review, and sign off on final submitted manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.