{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T15:31:22Z","timestamp":1778945482582,"version":"3.51.4"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,7,28]],"date-time":"2020-07-28T00:00:00Z","timestamp":1595894400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,28]],"date-time":"2020-07-28T00:00:00Z","timestamp":1595894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Cholesterol granuloma in the mediastinum is rarely observed, accounting for 1% of all mediastinum tumors. There have been only a few reports of multifocal cholesterol granulomas of the thymus. We herein report a rare case of multifocal cholesterol granuloma in the thymus that was incidentally detected during follow-up of an aortic aneurysm.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>The patient was a 70-year-old man with dyslipidemia and hypertension who was referred to our hospital to undergo an operation for chest aortic aneurysm. Preoperative computed tomography (CT) showed 4 lesions in the anterior mediastinum measuring up to 4\u2009cm in size with slight contrast enhancement and spotty calcification. Therefore, a thymoma, bronchogenic cyst, or lymphangioma were considered as the preoperative diagnosis. The patient underwent total thymectomy under thoracotomy followed by aortic arch replacement for the aortic aneurysm. The pathological diagnosis was multifocal cholesterol granulomas in the thymus.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Cholesterol granulomas should be included in the differential diagnosis of cystic tumor in the mediastinum, especially in patients with basal disease such as dyslipidemia and hypertension, which may lead to aortic aneurysm. Furthermore, complete surgical resection and a detailed histological evaluation are important for the accurate diagnosis and treatment.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40792-020-00943-5","type":"journal-article","created":{"date-parts":[[2020,7,28]],"date-time":"2020-07-28T07:51:47Z","timestamp":1595922707000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Multifocal cholesterol granulomas of the anterior mediastinum"],"prefix":"10.1186","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7444-6158","authenticated-orcid":false,"given":"Takehiko","family":"Manabe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soichi","family":"Oka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Ono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,7,28]]},"reference":[{"key":"943_CR1","doi-asserted-by":"publisher","first-page":"1509","DOI":"10.1016\/j.athoracsur.2005.03.019","volume":"81","author":"H Luckraz","year":"2006","unstructured":"Luckraz H, Coulston J, Azzu A. Cholesterol granuloma of the superior mediastinum. Ann Thorac Surg. 2006;81:1509\u201310.","journal-title":"Ann Thorac Surg"},{"key":"943_CR2","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1097\/JTO.0b013e318158eee8","volume":"2","author":"K Fujimoto","year":"2007","unstructured":"Fujimoto K, Takamori S, Yano H, Sadohara J, Matsuo T, Terazaki Y, et al. Focal cholesterol granuloma in the anterior mediastinum: [18F]-fluoro-2-deoxy-D-glucose-positron emission tomography and magnetic resonance imaging findings. J Thorac Oncol. 2007;2:1054\u20136.","journal-title":"J Thorac Oncol"},{"key":"943_CR3","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1007\/BF01928875","volume":"136","author":"P Manasse","year":"1894","unstructured":"Manasse P. Ueber granulationsgeshwulst mit fremdkoer-riesenzellen. Virchows Arch. 1894;136:245.","journal-title":"Virchows Arch"},{"key":"943_CR4","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/s00417-015-3178-9","volume":"254","author":"N Shrirao","year":"2016","unstructured":"Shrirao N. Mukherjee1 B, Krishnakumar S, Biswas J. Cholesterol granuloma: a case series & review of literature. Graefes Arch Clin Exp Ophthalmol. 2016;254:185\u20138.","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"943_CR5","doi-asserted-by":"publisher","first-page":"101","DOI":"10.2995\/jacsurg.22.101","volume":"22","author":"K Shindo","year":"2008","unstructured":"Shindo K, Kato M. A case report of cholesterol granuloma in the medianstinal region. Journal of Japanese Association for Chest Surgery. 2008;22:101\u20135.","journal-title":"Journal of Japanese Association for Chest Surgery"},{"key":"943_CR6","doi-asserted-by":"publisher","first-page":"150","DOI":"10.4081\/rt.2012.e47","volume":"4","author":"TF Ezzat","year":"2012","unstructured":"Ezzat TF, Alowami S. Cholesterol granuloma of the anterior mediastinum with osseous metaplasia. Rare Tumors. 2012;4:150\u20132.","journal-title":"Rare Tumors"},{"key":"943_CR7","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1016\/j.hlc.2012.07.009","volume":"22","author":"TR Krishnan","year":"2013","unstructured":"Krishnan TR, Sinha SK, Kejriwal NK. A rare case of cholesterol granuloma in the anterior mediastinum. Heart Lung Circ. 2013;22:303\u20134.","journal-title":"Heart Lung Circ"},{"key":"943_CR8","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1111\/pin.12403","volume":"66","author":"MR Ghigna","year":"2016","unstructured":"Ghigna MR, Dorfmuller P, Fadel \u00c9, Thomas de Montpr\u00e9ville V. Cholesteroloma: a rare thymic pseudotumor. Pathol Int. 2016;66:356\u20137.","journal-title":"Pathol Int"},{"key":"943_CR9","doi-asserted-by":"publisher","first-page":"58","DOI":"10.2995\/jacsurg.31.58","volume":"31","author":"T Kawai","year":"2017","unstructured":"Kawai T, Uehara H, Matsutani N, Saito K, Ishida T, Kawamura M. A case of cholesterol granuloma in the thymus. Journal of Japanese Association for Chest Surgery. 2017;31:58\u201362.","journal-title":"Journal of Japanese Association for Chest Surgery"},{"key":"943_CR10","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1136\/thoraxjnl-2016-209481","volume":"72","author":"NE Drury","year":"2017","unstructured":"Drury NE, Smith DN, Phillips LM, Trotter SE, Kalkat MS. Cholesterol granuloma of the anterior mediastinum. Thorax. 2017;72:671\u20132.","journal-title":"Thorax."},{"key":"943_CR11","doi-asserted-by":"publisher","first-page":"99","DOI":"10.2995\/jacsurg.32.99","volume":"32","author":"K Kobayashi","year":"2018","unstructured":"Kobayashi K, Mori M, Ashikari S, Iwata T, Yasuda M, Hanagiri T. A resected case of cholesteroloma in the anterior mediastinum. Journal of Japanese Association for Chest Surgery. 2018;32:99\u2013102.","journal-title":"Journal of Japanese Association for Chest Surgery"},{"key":"943_CR12","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1002\/rcr2.361","volume":"6","author":"S Nagata","year":"2018","unstructured":"Nagata S, Ishihara M, Omasa M, Nakanishi T, Motoyama H. Multifocal thymic cysts with cholesterol granuloma. Respirology Case Reports. 2018;6:361.","journal-title":"Respirology Case Reports"},{"key":"943_CR13","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1590\/S0066-782X2007000100007","volume":"88","author":"CRC Ferro","year":"2007","unstructured":"Ferro CRC, Cavalcanti-de-Oliveira D, Guerra FFG, Jorge-de-Lucena A, Nunes FP, Ortiz ST, et al. Prevalence of and risk factors for combined coronary artery disease and aortic aneurysm. Arq Bras Cardiol. 2007;88:37\u201340.","journal-title":"Arq Bras Cardiol"},{"key":"943_CR14","doi-asserted-by":"publisher","first-page":"2509","DOI":"10.3390\/ijms21072509","volume":"21","author":"J Nuche","year":"2020","unstructured":"Nuche J, Palomino-Doza J, Ynsaurriaga FA, Delgado JF, Ib\u00e1\u00f1ez B, Oliver E, et al. Potential molecular pathways related to pulmonary artery aneurysm development: lessons to learn from the aorta. Int J Mol Sci. 2020;21:2509.","journal-title":"Int J Mol Sci"},{"key":"943_CR15","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1007\/s00428-015-1822-8","volume":"467","author":"A Weissferdt","year":"2015","unstructured":"Weissferdt A, Kalhor N, Moran C. Primary thymic cholesteroloma: a clinicopathological correlation of four cases of an unusual benign lesion. Virchows Arch. 2015;467:609\u201311.","journal-title":"Virchows Arch"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-020-00943-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-020-00943-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-020-00943-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T23:10:15Z","timestamp":1627427415000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-020-00943-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,28]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["943"],"URL":"https:\/\/doi.org\/10.1186\/s40792-020-00943-5","relation":{},"ISSN":["2198-7793"],"issn-type":[{"value":"2198-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,28]]},"assertion":[{"value":"21 May 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"We got ethical approval from ethical committee of Kokura Memorial Hospital, Japan.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for the publication of the case details was obtained from our patient.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All the authors have declared no competing interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"182"}}