Chest wall mass: what lies beneath?

Emerg Med J. 2018 Oct;35(10):586. doi: 10.1136/emermed-2018-207503.

Abstract

Clinical introduction: A 24-year-old Filipino man attended the ED with a 1-month history of a discrete swelling over his upper anterior chest wall that was rapidly increasing in size and tenderness. He denied any other symptoms. His medical history was unremarkable.Examination revealed a tender, 7 cm × 6 cm mass over the upper part of the sternum (figure 1). The surface was smooth, it was immobile, non-compressible and the overlying skin was normothermic but mildly erythematous. Cervical lymphadenopathy was present. His vital signs were normal.emermed;35/10/586/F1F1F1Figure 1Chest wall mass.

Question: What is the most likely diagnosis?LipomaChondrosarcomaLymphoma Mycobacterium tuberculosis (TB).

Keywords: chest - non trauma; global health; imaging, ct/mri; infectious diseases, bacterial; musculo-skeletal, soft tissue infection.

MeSH terms

  • Humans
  • Lymphadenopathy / etiology
  • Male
  • Thoracic Wall / abnormalities*
  • Tuberculosis / diagnosis*
  • Tuberculosis / diagnostic imaging
  • Young Adult