Mediastinal tumor: not always a lymphoma

DOI: 10.1590/S1679-45082017AI3981 A 45-year-old male patient, hospitalized and under investigation of mediastinal mass, presenting with sudoresis, malaise, and dysphagia. Computed tomography showed eccentric parietal thickening of the middle third of esophagus, with mass effect and upstream ectasia, with no expressive increase of metabolic activity. Additionally, there are cervical, axillary, pulmonary hilar, portocaval space, and unspecific iliac lymph nodes (Figures 1 and 2). On endoscopy, it was noted that the tumor was related to the aortic arch, left atrium, esophageal wall, and main bronchi. Transesophageal ultrasoundguided punctures were performed. Pathological and immunohistochemical studies showed fusiform cells with no mitotic activity and necrosis, with expression of smooth muscle desmin and actin, concluding the diagnosis of leiomyoma (Figures 3 and 4). Figure 1. Computerized tomography. Lesion in the posterior mediastinum in contact with the main bronchi, descending aorta, and azygos vein