1. A 66-Year-Old Man With Mediastinal Mass and Dyspnea
Narendra Kumar Narahari, MD, FCCP, Paramjyothi K. Gongati, MD, Shantveer G. Uppin, MD, Anu Kapoor, MD, Bhaskar Kakarla, MD, Ramakrishna Dev Tella, MS, MCh 
CHEST 
Volume 150, Issue 4, Pages e109-e115 (October 2016)
DOI: /j.chest
Copyright © 2016 American College of Chest Physicians Terms and Conditions

2. Figure 1
A, Buccal mucosa. B, Inferior labial mucosa. C, Tongue showing white and violaceous lacy plaques, a few coalescing to form reticulate pattern on an erythematous base. A few erosions are also seen on the buccal mucosa. Plaque formation and brownish discoloration of teeth and gingivae also noted, indicating poor oral hygiene.
CHEST  , e109-e115DOI: ( /j.chest )
Copyright © 2016 American College of Chest Physicians Terms and Conditions

3. Figure 2
A, Chest radiograph shows a homogeneous opacity in right paracardiac region, with indistinct right cardiac border suggestive of an anterior mediastinal mass. In addition, faint nodularity is noted in both lung fields. B, Contrast-enhanced axial CT image of the chest shows a homogeneous soft-tissue lesion with calcification in right anterior mediastinum. C-E, High-resolution CT (HRCT) images in lung window settings reveal diffuse ground-glass attenuation of lung parenchyma with multiple tiny ill-defined randomly distributed nodules in both centrilobular and subpleural locations along the fissures (white arrows in C and D).
CHEST  , e109-e115DOI: ( /j.chest )
Copyright © 2016 American College of Chest Physicians Terms and Conditions

4. Figure 3
A and B, Section from the anterior mediastinal mass shows diffusely arranged monomorphous plump spindle cells admixed with lymphocytes. C, Section from lung biopsy sample shows peribronchiolar and interstitial lymphomononuclear infiltrates. D, Section shows thickened alveolar septa with infiltrates of predominantly lymphocytes and a few histiocytes. E and F, Interstitial aggregate of epithelioid cells and giant cells (arrow) forming ill-defined loose nonnecrotizing granuloma. G, CD3 positivity of lymphocytes in the interstitial infiltrate. H, Negative staining for CD20 in the interstitial lymphocytic infiltrate. I, CD68 highlights the histiocytes within the interstitial infiltrate.
CHEST  , e109-e115DOI: ( /j.chest )
Copyright © 2016 American College of Chest Physicians Terms and Conditions