Adenocarcinomas of unknown primary (ACUP) of the mediastinum mimicking lymphoma: CT findings at diagnosis and follow-up (original) (raw)
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CT Evaluation of Mediastinal Masses : A Study of 80 Cases
2018
Eighty patients with mediastinal masses were imaged with computed tomography (CT). Results were analyzed with regard to the ability of CT to demonstrate the masses, their location, their morphology, and their encroachment upon or displacement of adjacent mediastinal structures. CT images were compared with plain chest radiographs which were available in all cases. CT depicted all lesions successfully with good anatomic detail. Among the 80patients the largest number of cases (n =51) were found to be having lymphadenopathy with Hodgkin's lymphoma in 57% and non-Hodgkin's lymphoma in J5% of cases. CT is regarded as the best single radiological investigation for evaluating a mediastinal abnormality demonstrated on a high-kV chest radiograph or for detecting occult mediastinal disease.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2005
The study points out the value of CT scan in the investigative algorithm of mediastinal lymphomas. Thirty-eight cases of mediastinal malignant lymphoma were evaluated in a statistical retrospective study. CT scan was used for staging the disease in 25 cases and for post-therapeutic evaluation in the other 13 cases. The CT scan for staging purpose has shown the presence of significant isolated and confluent enlarged lymph nodes in the mediastinum in all 25 cases. Post-therapeutic evaluation of the 13 cases examined by CT showed six remissions, five reductions of lymph node masses and two extra nodal extensions. CT scan is the imaging method of choice in the clinico-morphological and anatomical assessment of mediastinal lymphomas.
A Mediastinal Mass: A Case of Acute Mediastinitis Posing as A Lymphoma
2019
A 22-year-old Caucasian man presented to the hospital with chest pain and fevers of one-week duration. His symptoms started after experiencing a loud eructation while drinking beer followed by retrosternal chest pain. He denied any tobacco or drug use. He had no recent travel or significant exposures. He had a history of childhood asthma and no surgical history. On examination, patient had a temperature of 38.5 °C, heart rate of 122 bpm and blood pressure of 95/48 mmHg. The remaining physical exam was unremarkable. Laboratory work up revealed a neutrophilic (82.5%) predominant leukocytosis of 18,000/μL. Electrocardiogram, chest radiograph and serum Troponin T were normal. A computed tomography angiography (CTA) of the chest revealed a soft tissue mediastinal mass involving the subcarinal region (figure 1) concerning for lymphoma. A bronchoscopy with endobronchial ultrasound -guided transbronchial needle aspiration of the subcarinal mass revealed evidence of inflammation with necrosi...
A 69-Year-Old With Lung Mass and Mediastinal Lymphadenopathy on Chest Computed Tomography
Clinical Gastroenterology and Hepatology, 2007
Abbreviations used in this paper: CT, computed tomography; EBUS, endobronchial ultrasound; EBUS-TBNA, endobronchial ultrasoundguided transbronchial needle aspiration; EUS, endoscopic ultrasound; EUS-FNA, endoscopic ultrasound-guided fine-needle aspiration; NSCLC, non-small-cell lung cancer; PET, positron emission tomography.
Huge complex mediastinal mass presenting as a rare variant of lymphoblastic leukemia/lymphoma
The Professional Medical Journal
The mediastinum is the space that separates the lungs from the rest of the chest. The most common mediastinal masses are neurogenic tumors (20% of mediastinal tumors), followed by thymoma (15-20%). Other masses include lymphoma, pheochromocytoma, germ cell tumors, including teratoma, thyroid tissue, and parathyroid lesions. Lymphoblastic leukemias/lymphomas are neoplasms of precursor T cells and B cells also known lymphoblasts. World Health Organization (WHO) classification has unified these entities as precursor B-cell and T-cell lymphoblastic leukemia/lymphoma. We present here a rare variant of non-Hodgkins lymphoma in a 12-year-old female who complained of worsening dyspnea and lower left-sided chest pain. The patient was empirically treated with anti-tuberculous drugs without relief. On admission, a CT scan chest showed an anterior mediastinal mass approximately 25x12.5 cm adherent to the mediastinal structures. Resection of the mass was done sparing the phrenic nerve. The sampl...
Helpful CT findings for giving specific diagnosis of anterior mediastinal tumors
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2010
To characterize the CT features of common anterior mediastinal tumors and evaluate CT findings that may help in suggesting specific diagnosis among these tumors. Fifty chest CT studies with pathological diagnosis of thymoma (n=28), mediastinal germ cell tumor (n=14) and lymphoma (n=8) were retrospectively reviewed by two radiologists who were blind to the pathological results. The CT findings of fat, cyst and calcification within the lesion, contrast enhancement, associated intrathoracic findings such as mediastinal invasion and lymph node enlargement were evaluated. Fat density within the mass was present in 57.1% with germ cell tumor which was significantly higher than other anterior mediastinal tumors (p < 0.05). The presence of associated mediastinal lymphadenopathy was significantly found in lymphoma (75.0%) compared to other tumors (p < 0.05). The other CT findings showed no significant difference among these diseases (p > 0.05). The CT findings that help in giving sp...
American Journal of Roentgenology, 1991
The aim of this retrospective study was to assess the diagnostic value of mediastinal sonography, compared with that of chest radiographs and CT, in the follow-up of patients with mediastinal bymphomas and in the prediction of clinical outcome. The sonograms, chest radiographs, and CT scans of 40 consecutive patients with Hodgkin (n = 29) and non-Hodgkin (n = I 1) lymphoma obtained before and after completion of therapy were analyzed blindly and independently by three radiologists and compared with clinical outcome. Nine patients were treated with radiotherapy, 12 with chemotherapy, and 19 with combined therapy. Therapeutic response was assessed from all available clinical and biochemical findings as well as from the combined results of all imaging studies performed on further follow-up. The sonograms showed obvious changes in the size and echogenicity of the mediastinab bymphomas that corresponded cbosely with the response to therapy. Sonography showed complete regression of the bymphomas in 30 patients who had complete remission. In five patients with incomplete remission, sonographic diagnoses were correct. All lymph nodes, irrespective of size, detected with sonography after a phase of complete remission indicated recurrence (five patients).
Applied Radiology Imaging of the mediastinum in oncology
Disclosures Appl Radiol. 2007;36(1) With the wide variety of mediastinal anatomic structures, tumors in this area include a heterogeneous group of primary and metastatic neoplasms. Most mediastinal abnormalities are detected on routine chest radiography, but further radiologic evaluation involves computed tomography (CT) or magnetic resonance imaging and may use positron emission tomography (PET) or integrated PET/CT. The authors review findings of mediastinal abnormalities as seen on a range of imaging modalities. The mediastinum is composed of various structures within the central portion of the thorax that are bounded by the lungs, the diaphragm, and the thoracic inlet. Because of this wide variety of anatomic structures, mediastinal tumors constitute a heterogeneous group of neoplasms, both primary and metastatic. Detection of mediastinal abnormalities requires familiarity with the chest radiograph, as most mediastinal tumors are discovered in asymptomatic patients on routine chest radiography. Once a mediastinal abnormality is detected by a chest radiograph, further radiologic evaluation involves cross-sectional imaging with computed tomography (CT) or magnetic resonance imaging (MRI) and may employ other imaging techniques, such as positron emission tomography (PET) or integrated PET/CT. This article will review fundamental radiologic findings of mediastinal abnormalities on chest radiographs and will address the salient features of mediastinal tumors on other imaging modalities, including CT, MRI, PET, and integrated PET/CT.Continue Reading The diagnostic evaluation of mediastinal disease requires a thorough understanding of mediastinal anatomy on chest radiography and cross-sectional imaging. Localizing and understanding the relationship of an abnormality to a mediastinal compartment or normal structure can provide a valuable clue for the diagnosis of a mediastinal mass. The chest radiograph is the most often performed radiographic examination, constituting more than 40% of the total volume of radiographs, with >50 million chest radiographs performed per year in the United States. [1] Therefore, it is important for radiologists to understand the appearance of normal structures and how they can be altered by disease. In particular, the detection of mediastinal disease can be difficult with conventional chest