51yr male patient with chief complain of cough and fever

 

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Doctor's Information

Name : mersad
Family : mehrnahad
Affiliation :mersad mehrnahad.resident of radiology.masih hospital.shahid beheshti university of medical sciences
Academic Degree : the second year resident
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : mersad mehrnahad

 

Case Section

Chest Imaging

 

Patient's Information

Gender : Male
Age : 28

 

Clinical Summary

51yr male patient with chief complain of cough and fever

 

Imaging Findings

anterior mediastinal mass associated with nodular and tree in bud infitration is noted. biopsy from anterior mediastinal mass was done.

 

Differential Diagnosis

thymoma
lymphoma
germ cell tumor
thyroid mass

 

Final Diagnosis

thymoma associated with infection

 

Discussion (Related Text)

Good syndrome is a rare cause of combined B- and T-cell immunodeficiency that occurs in association with a thymoma The association between the presence of a thymoma and immunodeficiency was first recognised in 1954 by Dr Robert Good, who described a case of thymoma and hypogammaglobulinaemia in an adult Patients with Good’s syndrome usually present in the 4th or 5th decade of life The initial clinical features of Good’s syndrome are varied.The initial diagnosis may be prompted by the finding of an asymptomatic anterior mediastinal mass on chest x ray. Patients may complain of symptoms secondary to the thymoma itself such as cough, chest pain, dysphagia, dyspnoea, and hoarseness The most common cause of infection in this patient population is recurrent sinopulmonary infection secondary to encapsulated organisms This disorder should be treated by resection of the thymoma and immunoglobulin replacement to maintain adequate trough IgG values

 

References

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