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Kim, Lee, Kim, Kim, Park, Lim, Ryu, Chun, Chang, Kim, Shim, and Sung: Spontaneous Massive Hemothorax Associated with Solitary Posterior Mediastinal Neurilemmoma
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 65(5): 426-429.

Published online: 30 November 2008

DOI: https://doi.org/10.4046/trd.2008.65.5.426

Spontaneous Massive Hemothorax Associated with Solitary Posterior Mediastinal Neurilemmoma

In Seon Kim, M.D.1, Jin Hwa Lee, M.D.1, Kwan Chang Kim, M.D.2, Yoo Ri Kim, M.D.1, Jin Kyeong Park, M.D.1, So Yeon Lim, M.D.1, Yon Ju Ryu, M.D.1, Eun Mi Chun, M.D.1, Jung Hyun Chang, M.D.1, Yoo Kyung Kim, M.D.3, Sung Shin Shim, M.D.3, Sun Hee Sung, M.D.4

1Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

2Department of Thoracic Surgery, Ewha Womans University School of Medicine, Seoul, Korea.

3Department of Radiology, Ewha Womans University School of Medicine, Seoul, Korea.

4Department of Pathology, Ewha Womans University School of Medicine, Seoul, Korea.

Address for correspondence: Jin Hwa Lee, M.D., Ph.D. Department of Internal Medicine, Ewha Womans University School of Medicine, 911-1, Mok-dong, Yangcheon-gu, Seoul 158-710, Korea. Phone: 82-2-2650-6007, Fax: 82-2-2655-2076, jinhwalee@ewha.ac.kr

Received 8 September 2008       Accepted 17 September 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Neurogenic tumors are common in posterior mediastinal tumors and neurilemmoma represents approximately 40% of neurogenic tumors arising in the mediastinum. It is usually asymptomatic, and is generally diagnosed incidentally. In some cases, they presented with symptoms of nerve or airway compression. However, a solitary neurilemmoma, particularly not associated with von Recklinghausen disease, with spontaneous hemothorax is quite rare. We report a case of spontaneous massive hemothorax associated with a solitary neurilemmoma.

Keywords: Hemothorax, Neurilemmoma, Mediastinum, Neurogenic tumor

Figures and Tables

Figure 1
Chest X-ray shows a solitary, well-defined mass in the left upper lung.
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Figure 2
Chest CT scan reveals a well-defined cystic mass in the left upper posterior mediastinum. While a part of the mass is located in the neural foramen of the left T2-3 level (arrow), it does not extend to the spinal canal and the fat plane between dural sac and the mass is intact.
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Figure 3
Chest X-ray shows a large amount of pleural effusion in the left hemithorax, associated with deviation of trachea and heart to the right.
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Figure 4
Chest CT scan shows the mass in the left posterior mediastinum and newly appeared pleural effusion with high attenuation, suggesting hemothorax.
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Figure 5
(A) A surgical specimen of the mass reveals hypercellular Antoni A area and loose-organized Antoni B area with some hemorrhage (H&E stain, ×100). (B) Immunohistochemical stain reveals a strongly positive reaction with S-100 protein (S100 staining, ×100).
trd-65-426-g005

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