Cystic degeneration of thymic Hodgkin's disease following radiation therapy.

A case of thymic Hodgkin's disease presenting with an anterior mediastinal mass is reported. The mass progressively expanded in size on plain chest radiography during and following a mantle radiation therapy. A repeat computed tomographic (CT) scan of the chest in this patient revealed a cystic component to the mass, and thin-needle aspiration of the cyst led to a shrinkage of the mass. An experience in this case and review of literature suggest Hodgkin's disease involving the thymus gland frequently predisposes to cystic degeneration especially following radiotherapy, leaving a stable or progressively enlarging residual mass. A precise diagnosis of such a progressively expanding mass despite the adequate radiation therapy is crucial. CT scan of the chest in such cases and a thin-needle aspiration of the cystic mass offer precise diagnosis and may obviate the need for an open thoracotomy procedure.