title: [The rare differential diagnosis of a mediastinal space-occupying lesion].
abstract: METHODS
  Two months before admission a 31-year-old man first noted a painless swelling on the right side of his neck without any associated symptoms. Physical examination revealed a painless right cervical node 4 cm in diameter.
  
  
  METHODS
  Magnetic resonance imaging demonstrated a large right-sided cervical tumour which extended into a mediastinal mass 11 cm in diameter. The excised cervical node showed a Hodgkin's lymphoma. Further tests to stage the disease revealed a 1.5 cm tumour in the right testis. Removal of the latter showed a mixed testicular tumour. Mediastinoscopic biopsy confirmed Hodgkin's lymphoma of the mediastinal mass.
  
  
  METHODS
  Standard chemotherapy of the Hodgkin's lymphoma was undertaken, followed by "extended field" radiation which has so far secured a remission of two years.
  
  
  CONCLUSIONS
  Histological diagnosis is always essential in the case of an unusual tumour location so that a synchronous second tumour may be revealed. If there is a second tumour, exact histological classification with definitive staging of the tumours is necessary to ensure adequate treatment.
authors: Abteilung für Allgemeine Innere Medizin, Katharinenhospital Stuttgart.
authors: W
authors: W
authors: Bohle
authors: U
authors: U
authors: Rüther
authors: P
authors: P
authors: Jipp
mesh_terms: D000328:Adult; D001706:Biopsy; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D018237:Germinoma / Q000175:diagnosis* / Q000628:therapy; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000628:therapy; D008482:Mediastinum / Q000473:pathology; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000628:therapy; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000628:therapy; D013737:Testis / Q000473:pathology