A Weighty Diagnosis: Chest Mass In A Young Weightlifter

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A Weighty Diagnosis: Chest Mass In A Young Weightlifter - Page #3

Lab Studies: IR guided biopsy of the chest wall mass revealed Burkitt lymphoma with atypical BCL2 expression, EBV positive C-MYC rearranged by FISH. Labs: HIV+, CD4 317, EBV PCR >57000 Other Studies: X-ray of right shoulder showed normal alignment, no acute pathology Case Photo #1 . Chest MRI without contrast showed a large bilobed mass deep to the right pectoralis muscle occupying much of the right chest wall with extension inferomedially into the axilla. The superior lobe measured 8.4 x 11.7 x 11.9cm and the inferolateral lobe 8.2 x 8.5 x 9.4cm. This lesion is predominantly hyperintense on T2-weighted images with some internal septations within it. The radiology report noted that it is highly concerning for malignancy, such as a sarcoma. Multiple enlarged right axillary lymph nodes were present, the largest measuring 3.0 x 1.8 cm transaxially. An enlarged right internal mammary lymph node and supraclavicular lymph node were also present. Edema was seen within the right pectoralis muscle, but no tear or rupture. Case Photo #2 Case Photo #3 Case Photo #4 Consultations: Orthopedic surgery, Medical oncology Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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