RT Journal Article SR Electronic T1 Cholesterol granuloma of the anterior mediastinum with osseous metaplasia JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP PA2521 DO 10.1183/13993003.congress-2016.PA2521 VO 48 IS suppl 60 A1 Premjithlal Bhaskaran A1 Maria Montero Fernandez A1 Georgia Hardavella A1 Jaymin Morjaria A1 Nikolaos Anastasiou YR 2016 UL http://erj.ersjournals.com/content/48/suppl_60/PA2521.abstract AB Cholesterol granuloma is a well-characterized entity comprised of a foreign-body giant cell-reaction that forms in response to the presence of cholesterol crystals1. It is usually found in the middle-ear or mastoid process in patients with diseases associated with chronic inflammation such as cholesteatoma and otis media. They are rarely seen in the mediastinum. In fact osseous metaplasia is an exceedingly rare feature of cholesterol granulomas only reported three times inliterature. Here we report a case of a 67 year old woman who was referred to us for evaluation of a incidental mediastinal mass that was identified while investigating the aetiology of anaemia, which was resected. Histological identification revealed a cholesterol granuloma. She had an uneventful recovery and was discharged from any further follow-up. This case identifies an incidental cholesterol granuloma of the anterior mediastinum with osseous metaplasia, a rare finding. Anterior mediastinal masses can have a sinister aetiology and present with or without clinical symptoms. It is prudent to investigate them and if appropriate resection is the treatment of choice.