Cholesterol granuloma. Another brick in the wall of mediastinal lesions

Dear Editor-in-Chief,

A 57-year-old man underwent about two years ago a coronary arterial bypass and a total thyroidectomy for ischemic heart disease and diffuse multinodular goitre, respectively. A routine follow-up cardiac magnetic resonance imaging (MRI) revealed the presence of a newly developed, expansive lesion in the anterior mediastinum. This lesion was further investigated by total body computed tomography (CT) scan, which showed a 22x20 mm mediastinal lesion, with a lymph node measuring 8 mm in maximum diameter within the adjacent fat tissue. A further MRI confirmed the presence of both mediastinal and lymph node findings, raising the strong suspicion of heteroplastic lesion.