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J Thorac Cardiovasc Surg 2003;125:400-406
© 2003 The American Association for Thoracic Surgery

Clinical-Pathologic Conference (CPC)

Clinical-pathologic conference: Cutaneous paraneoplastic pemphigus associated with benign encapsulated thymoma

From Tulane University Health Sciences Center, New Orleans, Louisiana

Received for publication Feb 7, 2002. Accepted for publication Feb 10, 2002. Address for reprints: Renee Hartz, MD, Tulane University Health Sciences Center, Department of Surgery, SL 22, 1430 Tulane Ave, New Orleans, LA 70112 (E-mail: rhartz@tulane.edu).

The first 300 words of the full text of this article appear below.

	Introduction

 
Participants

From Tulane University Health Sciences Center New Orleans, Louisiana

THORACIC SURGERY
Dr Renee Hartz

PATHOLOGY
Dr Philip Daroca

PULMONARY MEDICINE
Dr Luis Ortiz

RADIOLOGY
Dr Richard Campeau

DERMATOLOGY
Dr Erin Boh
Dr Larry Millikan

GYNECOLOGY
Dr Roberta Lottinger

	Case presentation

 
Dr Ortiz: The patient is a 62-year-old woman with a 90-pack-year smoking history who was seen with a chief complaint of intermittent skin lesions over her trunk and extremities for the past 3 years. The lesions had recently grown in size, and a large painful ulceration had appeared in her left groin. An extensive evaluation of the maculopapular skin lesions had been undertaken previously, and the working diagnosis of her dermatologist was Grover's disease. ¹ During my evaluation a routine chest radiograph revealed an anterior mediastinal mass, which was verified by computed tomography to be a 7.5-cm circumscribed contrast-enhancing mass. On examination the patient appeared healthy, and her vital signs were within normal limits. Pertinent findings included distant breath sounds and a rash over her chest and extremities, which will be described in detail by Dr Boh. There was also an ulcerated lesion several centimeters in size in her left vulvar area, and this lesion will be addressed by Dr Lottinger. In anticipation of surgical removal of the patient's anterior mediastinal mass, pulmonary function tests were performed. Spirometry revealed a forced vital capacity that was 79% of predicted and a forced expiratory volume in 1 second that was 59% of predicted. Residual volume was 115%. The patient's electrocardiogram was abnormal, as were results of an exercise stress test. She therefore underwent cardiolyte stress testing with sestamibi, which demonstrated no ischemic changes; however, the mediastinal mass was evident, as will be discussed by Dr Campeau. The patient was then referred to Dr Hartz for surgical excision of the mass.

Dr Campeau: Computed chest . . . [Full Text of this Article]

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