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[Cholesterol Granuloma Arising in the Thymus:Report of a Case]

Kenji Kimura1, Norimasa Itou, Masahiro Yoshimura

  • 1Department of Thoracic Surgery, Saiseikai Hyogo Prefectural Hospital, Kobe, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|July 1, 2025
PubMed

Insights

A rare cholesterol granuloma in the thymus was diagnosed in a 64-year-old man after a chest CT scan revealed an abnormal shadow. Surgical resection was necessary for definitive diagnosis and to rule out malignancy.

Area of Science:

  • Thoracic surgery
  • Pathology
  • Diagnostic imaging

Background:

  • Anterior mediastinal masses can present diagnostic challenges.
  • Cholesterol granuloma is a rare condition, often associated with trauma or inflammation.
  • Distinguishing benign from malignant mediastinal lesions is critical.

Purpose of the Study:

  • To report a case of cholesterol granuloma of the thymus.
  • To highlight the diagnostic difficulties and the role of surgery.

Main Methods:

  • A 64-year-old male patient underwent chest computed tomography (CT) for an abnormal anterior mediastinal shadow.
  • Thoracoscopic thymic and thymic tumor removal was performed.
  • Histopathological examination of the resected tissue was conducted.

Main Results:

  • Histopathology revealed foreign body giant cells and cholesterol crystals, confirming cholesterol granuloma.
  • The patient had a history of chest trauma eight years prior.
  • The postoperative recovery was uneventful, with discharge on the 4th day.

Conclusions:

  • Cholesterol granuloma of the thymus is rare and can mimic other mediastinal pathologies.
  • Imaging findings are often non-specific, necessitating surgical intervention for diagnosis.
  • Surgical resection is crucial for differentiating cholesterol granuloma from malignant thymic tumors.

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