Seeking Insights on Anterior Mediastinal Mass
Greetings, everyone! This is my inaugural post on Reddit, so please bear with me as I navigate through my thoughts. I’m a 34-year-old female and recently discovered an incidental finding of a mass measuring 3.9 x 1.5 x 1.9 cm during a CT scan that was performed due to tapering in my jugular vein. For the past year, I've experienced symptoms such as shortness of breath and localized chest discomfort. Initially, my medical team and I attributed these issues to ankylosing spondylitis (AS), which I have, assuming it was affecting my ribs and sternum. However, this suspicion was never substantiated by imaging; it was primarily a theory on my part. I have also been grappling with severe fatigue, intermittent fevers, and night sweats, which I believed were linked to my existing health complications. I now question if this mass might have been the underlying cause all along. Here are some pertinent aspects of my medical history: - I have a long-standing issue with reactive lymph nodes, with two currently being monitored via ultrasound every few months. They appear reactive according to the ultrasound results. - There is a familial tendency towards hereditary hypertension that has been challenging to manage. Presently, I'm on a combination of amlodipine and lisinopril and have previously taken carvedilol. - I'm on atorvastatin to address hyperlipidemia. I maintain an active lifestyle, have a healthy weight, and follow a clean diet, adhering to a vegetarian lifestyle for nearly 28 years. - I also have ankylosing spondylitis, for which I’m undergoing treatment with biologics. - My family background includes extensive occurrences of cancer and heart-related conditions. My father passed away from a heart attack at age 40, and both his brothers and father suffered heart attacks before turning 50, though they survived. My mother’s side has a significant cancer history, with three of her sisters surviving different types. Switching back to the mass, it presents with low density on imaging. It was initially noted on a 2022 CT scan when I was evaluated for chronic bronchitis and pneumonia, but regrettably, this finding was not communicated to me. The ENT who ordered the scans relayed the information to an interventional radiologist. After reviewing my imaging history, the radiologist informed me of the previous findings. He mentioned that the mass hadn't increased in size, which is reassuring in regard to malignancy risk, but suggested a follow-up MRI with contrast, as my arm positioning differed between the two scans. I just completed that MRI today. Upon reviewing my medical chart ahead of a forthcoming appointment, I came across an addendum pertaining to this year’s CT that includes: - "A lobulated low-density lesion in the anterior mediastinum measuring 3.9 x 1.0 x 1.9 cm has been identified, consistent with a similar lesion from 2022, which measured 3.3 x 2.0 x 1.5 cm. The size has not shown significant change, though it’s crucial to note the arm positioning discrepancy between the studies. The stability observed tends to suggest a benign nature." To further clarify, the original 2025 CT mentioned a low-density lobular lesion in the anterior mediastinum measuring 3.5 x 1.0 x 1.9 cm. It seems there are variances in size reported for the mass over time, and I am concerned because it appears to have changed not just in size but potentially in shape, especially given my symptoms and its location. Additionally, recent lab tests indicated I have low potassium and iron levels, alongside mildly elevated neutrophils. I insisted on being referred to a thoracic surgeon, and my doctor facilitated that without hesitation. I'll be seeing him soon. My primary questions are: - In light of my symptoms, the growth of the mass, and my family history, would it be wise to consider a biopsy? - Based on its size, location, and my symptoms, would surgical removal be advisable? If so, what implications should I anticipate? - Can anyone explain the differences in reported size across the radiology reports? Might the MRI reveal a different measurement compared to the CT? - Finally, how serious is this finding? I apologize for the lengthy post; I feel quite overwhelmed and am searching for some clarity on this matter. I truly appreciate any thoughts or guidance you can provide. I'm also happy to answer any additional questions you might have.
Answers (1)
8/20/2025, 3:01:45 AM
OpenHealth AI
Thank you for sharing your situation; it’s understandable to feel overwhelmed by these findings, especially with your existing health conditions and family history. Let’s break this down into the main points and provide some insights and next steps for you.
Main Points:
- You have an anterior mediastinal mass that has been stable in size over time, which may suggest a benign nature, but it's important to investigate it further due to your symptoms.
- Considering your family history of malignancies and your ongoing symptoms, further evaluation (including possible biopsy) is reasonable.
- Differences in size measurements between CT and MRI can occur due to various factors, including positioning and imaging technique.
Explanation:
-
Mass Characteristics: The fact that the mass has remained stable in size is reassuring; however, your symptoms (shortness of breath, chest discomfort, fatigue, intermittent fevers, and night sweats) warrant careful evaluation. A mass in the anterior mediastinum can be related to various conditions, including benign processes (like thymoma or teratoma) or, less commonly, malignancies.
-
Family History and Symptoms: Given your family history of cancer and heart disease, along with your concerning symptoms, it is sensible to consider a biopsy. A biopsy can provide a definitive diagnosis and guide further management.
-
Variability in Measurements: Variations in reported sizes across imaging studies may result from different positioning, breathing techniques during the scan, or differences in image interpretation by radiologists. It is common for small discrepancies to occur, and the MRI may help provide additional clarity concerning the mass’s characteristics.
Next Steps:
-
Discuss Biopsy with Your Thoracic Surgeon: Bring up the possibility of a biopsy during your appointment. Explain your symptoms and family history. A biopsy can yield valuable diagnostic information to clarify the nature of the mass.
-
Follow-Up on MRI Results: While you wait for the thoracic surgeon appointment, ensure you understand the findings of the recent MRI. Ask for clarification on how this imaging might change or confirm the understanding of the mass's characteristics.
-
Prepare for Discussion on Surgical Options: If a biopsy indicates that surgical removal is an option, your surgeon will discuss the potential benefits and risks with you. Surgical interventions can vary, but understanding what to expect will help you feel more prepared.
-
Monitor Symptoms: Keep a log of your symptoms, noting when they occur and their severity. This information can be invaluable in discussions with your healthcare team and during your surgical consultation.
Support:
It’s natural to feel anxious in situations like this. Surround yourself with supportive friends or family who can help you through this process. Remember, gathering thorough information and asking questions will help you feel more in control as you navigate your care.
Feel free to reach out if you have more questions or need emotional support during this time. You are not alone in this.
Related Questions
Battling Chronic Nausea and Vomiting for Over Two Years
For the past two years, I (age 26, female) have been enduring an incredibly challenging health situation. I experience intense nausea daily and find myself vomiting numerous times, with almost nothing providing relief. To provide some background, I’m from West Texas and I currently weigh around 190 pounds, standing at 5’7”. Initially, my weight was about 211 pounds when these symptoms began, and it fluctuates frequently between 190 and 225 pounds. I engage in vaping and consume THC. Previously diagnosed with hypothyroidism, my condition seemingly resolved, according to my healthcare providers. Additionally, I have polycystic ovarian syndrome (PCOS). I have consistently faced irregular bowel movements, with stools that are loose and sometimes appear to have mucus. Compounding my struggles, I've also suffered from migraines. I have had an IUD for over five years, experiencing two insertions of the Kyleena device. In December 2022, my battle with health took a severe turn when I was diagnosed with stage 4 Hodgkin’s Lymphoma, requiring chemotherapy treatment, specifically AVBD (Apologies for not recalling the exact medication names). By July 2023, I had fortunately achieved remission. However, after reaching remission, my vomiting worsened, transforming from primarily white foam to a mixture of 80% bile, any food I attempt to consume, and still white foam. This intense vomiting, accompanied by significant pain in my upper back, escalated to more than eight episodes daily by November 2023. At that time, THC seemed to be the only avenue for me to retain any food. During this tumultuous period, I consulted various doctors who, after confirming I wasn’t pregnant, attributed my symptoms to Cannabinoid Hyperemesis Syndrome (CHS). Immediately, I ceased THC consumption for over six months, yet the vomiting continued unabated. Each time, doctors would prescribe ondansetron, regardless of my claims that it provided no relief. I experimented with various diets recommended by medical professionals, but there were no improvements in my condition. Eventually, I obtained a referral to a gastroenterologist who intended to perform an endoscopy. However, the procedure was prohibitively expensive even with insurance, and thus was never conducted. This doctor also ordered blood tests to rule out several gastrointestinal disorders, such as Crohn's disease, Irritable Bowel Syndrome (IBS), and gluten sensitivity, but all results came back normal. Afterward, I had another appointment with a different gastroenterologist, but the doctor failed to meet with me. Instead, a nurse informed me that the doctor had merely recommended promethazine without conducting any tests or scheduling further visits. When I mentioned the possibility of gallbladder issues, the doctor laughed dismissively at my suggestion. Discussing my situation with my oncologist, he suggested that my heightened sensitivity to food odors stemmed from my chemotherapy experiences while I was working in fast food. While food smells indeed affect me, I'm primarily triggered by medical scents such as rubbing alcohol and cleaning agents. This ongoing ordeal has been overwhelmingly distressing. I now experience episodes of vomiting accompanied by bright red blood, presumably due to a throat tear. When I first encountered this troubling symptom, I consulted a doctor who appeared unfazed and prescribed a promethazine suppository, which does help but makes me extremely drowsy. My nausea persists nearly around the clock, often feeling as if there’s a heaviness in the upper part of my abdomen. I frequent urgent care facilities when my symptoms intensify, only to be met with minimal assistance since this is a chronic issue. Currently, I lack a primary care physician. Whenever I sought one, I encountered skepticism regarding my condition, with some healthcare professionals implying that I was exaggerating my symptoms. Though many physicians who do take my situation seriously seem baffled, I've lost count of the diverse medical experts I've consulted about these ongoing issues. If anyone has insight or suggestions, I would genuinely appreciate it. I can share my latest bloodwork results if that would be helpful—just let me know!
Strange Stomach Sensation Leading to Waking Up
Greetings. I'm a 36-year-old male, standing at 172 centimeters and weighing 90 kilograms. I don't take any medications, nor do I smoke. I've been living with diastasis recti for several years now, and I may also have irritable bowel syndrome (IBS). Additionally, I deal with fatty liver and kidney stones, though I assume these last two conditions are not related to my current concern. Occasionally, I experience a peculiar sensation that jolts me awake; it feels like a quick pulsing in my stomach. I’ve noticed it tends to affect the left side when I’m lying on my left side and the right side when on my right. Remarkably, it can occur even when I’m on my back. This strange feeling often escalates into a surge that fully rouses me. Alongside this, I sometimes feel prickling sensations throughout my body and fleeting lightheadedness. When this sensation disturbs my sleep while I’m turned to my side, shifting onto my back or the opposite side might alleviate it, but not always. In instances where I awaken while lying on my back, I discovered that gently pressing my hands on either side of my stomach can help, as can rising to a sitting or standing position. However, during my last two episodes—one a couple of weeks ago and another tonight—those techniques weren’t effective right away, which made me feel a bit anxious, prompting me to seek advice. Does anyone have insight into what might be going on? By the way, I’ve undergone routine ultrasound examinations of my abdomen by two different physicians during check-ups, both of whom assured me that everything appears normal, including my abdominal aorta and internal organs. They didn’t identify any issues at that time.
24M | Unexplained Fainting Incident
**Note:** I previously shared this story, but it was inexplicably removed. I’m a 24-year-old male without any medical diagnosis or prescription medications. While I do consume alcohol occasionally, I hadn’t been drinking before this happened. Around 3 a.m., I got up from bed to use the restroom. As soon as I began to urinate, I suddenly felt a wave of dizziness. The next moment I was aware of was regaining consciousness in the bathtub, startled awake by the sensation of something dripping on me—only to discover it was my own blood. This was my first experience with fainting. When I came to, confusion set in. I was disoriented and couldn’t comprehend why I was being dripped on while in what I thought was my “bed.” Strangely, I also imagined that I was lying on a collection of marbles (which I actually don’t own)—this turned out to be the shattered glass of my shower door lying around me. I’m uncertain whether I lost consciousness first and then fell, or if the fall caused my brief blackout. It took me a few moments to understand why I was in the bathroom at all. I’m not sure how long I was out; I only remember it was around 3 in the morning when I initially got up, and about the same time when I regained consciousness. I dialed 911, and the ambulance arrived promptly. They checked my vitals, performed an EKG and measured my blood sugar, finding nothing unusual. At the emergency room, they repeated the vital checks, conducted a CT scan, drew blood, and took x-rays—yet still no abnormalities were detected. I had several cuts on my face and left arm (curiously, this is the arm that would have been turned away from the door), along with bruising around my ribs. Since the incident, I’ve been suffering from headaches and pain in my ribs. I received stitches on both my face and arm. The nurse suggested I could have stronger pain relief, but I opted for just Toradol. They eventually discharged me, stating, "We’re unsure what caused this, but return if it happens again." What might have triggered such an incident? How can I safeguard against it reoccurring if they remain uncertain about the cause?
Swelling Beneath My Chin Near the Jawline
18-Year-Old Male: I'm reaching out to any medical professionals who might provide insights into my situation. I've been using marijuana since I was 14, but now, at 17, I'm making an effort to stop and have been clean for 18 days. Recently, I've discovered an unusual swelling located just beneath my chin, behind my jaw. It causes some discomfort when I move, yet it doesn’t feel painful continuously. I'm somewhat anxious that this could be indicative of a more serious issue, especially considering it's positioned near my chin's lymph nodes. Any advice or information would be greatly appreciated as it might help alleviate my worry.
Challenges with Appetite and Discomfort While Eating — Difficulty in Gaining Weight
As an 18-year-old male, I find that I become satisfied after consuming rather minimal amounts of food. This situation presents a considerable challenge, particularly since I only need to have a standard breakfast, lunch, or dinner to feel completely satiated for the remainder of the day. My goal of increasing my weight has made this issue even more complicated. When I limit myself to one meal per day, I often face weight loss or an uncomfortable sensation of fullness that leaves me feeling sluggish. Opting for two meals makes me feel excessively bloated, distracting me from my daily responsibilities. Moreover, I suffer from an unusual issue with my throat, where almost any food I consume causes discomfort, as detailed in the list below. I have contemplated focusing on having just lunch while continuing my weightlifting regimen to maintain my current weight and gradually build muscle. What advice could you offer? Could there be an underlying cause for these symptoms? Lastly, would it be wise for me to consult a healthcare professional? Foods That Cause Discomfort: Bread, flour, pizza, fruits, sugary or starchy items, seed oils, chips, and essentially everything else. Foods That Are Tolerable: Rice, salads, chicken, fish, and vegetables. Overall Symptoms Include: * Quick satiety after normal meals * Challenges in gaining weight * Bloated and lethargic sensations when consuming more than one meal * Persistent throat sensitivity to a wide variety of foods