Tuberc Respir Dis.  2008 Nov;65(5):426-429.

Spontaneous Massive Hemothorax Associated with Solitary Posterior Mediastinal Neurilemmoma

• Kim IS
• Lee JH
• Kim KC
• Kim YR
• Park JK
• Lim SY
• Ryu YJ
• Chun EM
• Chang JH
• Kim YK
• Shim SS
• Sung SH

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.

Keyword

Hemothorax; Neurilemmoma; Mediastinum; Neurogenic tumor

MeSH Terms

Hemothorax
Mediastinum
Neurilemmoma
Neurofibromatosis 1

Figure

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  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).

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