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A 35-year-old man with sickle cell disease presented with dyspnoea and chest pain, and was found to have an apparently enlarged cardiac silhouette on plain chest radiograph (figure 1). A subsequent CT pulmonary angiogram followed by contrast MRI of the thorax (figure 2; T2 coronal fat-saturated MRI) revealed a multiloculated anterior mediastinal lesion with T2 high-signal cystic components and enhancing septa. A percutaneous biopsy showed thymic follicular hyperplasia. The lesion …
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