An Unusual Location for a Lymph Node

Abstract

We report a case of a 67-years old non-smoking female diagnosed with hypertension when 24-years-old and complicated with chronic kidney and hypertensive heart diseases. On CT-Chest an incidental discovery of a lesion (16x14x23mm) adjacent to the abdominal aorta was made. Initially suspected to be paraganglioma, a hypothesis which the subsequent MRI did not exclude. Urine analysis showed normal Metanephrine with slightly elevated Chromogranin-A levels.

During VATs-procedure "bulging" below the adventitial layer of the descending aorta at the level of the diaphragmatic gutter was identified. By opening the adventitia, a lipomatous lesion with a nodular, consistent center was identified and excised.

Final histopathological report confirmed the diagnosis of lymph node not suggestive of neoplasia.

Currently, 12 months after the surgery, the patient’s condition is good being under surveillance in the Thoracosurgical Outpatient Clinic.

Despite not having identified any neuroendocrine component, the patient had clinical signs of clear improvement of arterial hypertension.