Imaging of invasive thymoma in the costophrenic recess presenting as thickening of arcuate ligaments of the diaphragm

• Published in: Clinical imaging Vol. 38; no. 4; pp. 529 - 531
• Main Authors: Coakley, Fergus V, Grant, Michael John, Behr, Spencer, Foster, Bryan R, Korngold, Elena K, Didier, Ryne A
• Format: Journal Article
• Language: English
• Published: United States Elsevier Limited 01-07-2014
• Subjects: Adult; Biopsy; Breast cancer; Diaphragm - diagnostic imaging; Diaphragm - pathology; Female; Fluorodeoxyglucose F18; Humans; Ligaments - diagnostic imaging; Magnetic Resonance Imaging; Male; Medical imaging; Metastasis; Middle Aged; Patients; Positron-Emission Tomography; Radiology; Thymoma - diagnostic imaging; Thymoma - pathology; Thymus Neoplasms - diagnostic imaging; Thymus Neoplasms - pathology; Tomography, X-Ray Computed; Ultrasonic imaging; Germany; FDG/PE; Computed tomography; Thymoma; Lateral; Arcuate ligament
• ISSN: 0899-7071; 1873-4499
• DOI: 10.1016/j.clinimag.2014.02.002

Abstract Imaging findings in a patient with invasive thymoma in the costophrenic recess are presented, in whom computed tomography (CT) and MRI revealed lateral arcuate ligament thickening. Increased fluoro-deoxy-glucose (FDG) uptake on subsequent positron emission tomography (PET)/CT was helpful in suggesting the correct diagnosis. A second patient with much more obvious invasive thymoma occurring in the costophrenic recess is presented for comparison. It is a well-known fact that thymic malignancies can metastasize to the pleura even years after resection. Rarely, they may present as focal thickening of the diaphragmatic lateral arcuate ligament.