In this Through the Lens case, we examine a 12-month-old who died of carbon monoxide poisoning. Dr. Jamie Elifritz highlights the hyperdensity along the right heart border (outlined in yellow) and explains how this age-appropriate finding represents the thymus, not hemorrhage.
Case: What is the etiology of the hyperdensity along the right heart border (between the two yellow arrows) in this 12-month-old?
Children are not little adults. This is an age-appropriate thymus in a 12-month-old who died of carbon monoxide poisoning.
Misinterpreting a normal thymus as a mass or hemorrhage is a common error when interpreting pediatric imaging through an adult lens. Determination of normal from abnormal findings in the thymic bed on PMCT in the pediatric population is a fundamental skill[1, 2].
- Çolak, E. and B. Özkan, Multidetector Computed Tomographic Evaluation of the Normal Characteristics of the Thymus in the Pediatric Population. J Belg Soc Radiol, 2022. 106(1): p. 110.
- Abe, S., et al., Evaluation of thymic volume by postmortem computed tomography. Legal Medicine, 2015. 17(4): p. 251-254.
