Mediastinal lymphomas: Differential diagnosis (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.
Diagnostic approach to mediastinal masses
European Journal of Radiology, 1998
Mediastinal masses represent a vast group of tumours and pseudo-tumours which can involve the various compartments of the mediastinum. The authors propose a radiologic diagnostic approach starting from the plain thoracic radiograph with study of the mediastinal lines and oesophageal transit and going on to the classifications made possible by modern CT and MR imaging. The proposed diagnostic procedure is based on nine mediastinal lines and two 'threads of Ariadne' which are the compartments where the masses are located and their behaviour at CT (densitometry before and after administration of an iodinated bolus) and at MRI (T 1 , T 2 , gadolinium-enhanced T 1-weighted sequences). The definitive aetiological diagnosis may be established by surgery, but also in certain cases by percutaneous needle biopsy.
Mediastinal Tumors: A Clinicopathological Study with Special Reference to Immunohistochemistry
Introduction: Mediastinum is located in the central part of the chest cavity splitting into the superior, anterior, middle and posterior compartments. They represent a wide diversity of disease states. So, the location and composition of a mass is significant in confining the differential diagnosis. Aims: To study the frequency, location and distribution of various pathologically diagnosed masses and correlate their clinical, histological and immunohistochemical (IHC) findings. Settings and Design: This was a cross-sectional observational study conducted for two years at a tertiary care hospital with a sample size of 40. Materials and methods: Detailed history taking, clinical examination and investigations were carried out. The tumor masses were excised and were sent for histopathological reporting. Immunohistochemistry was also performed. Statistical analysis used: Microsoft excel 2016 and SPSS 18 (SPSS, Inc., Chicago, IL, USA). Results: The present study includes total 40 cases with male: female ratio 1.22:1. Most common age group of mediastinal disease was 31-50 years (Mean: 32.2). Anterior mediastinum was the most common site (35.00%). The most common nature of the disease was benign 28 cases (70 %) followed by malignant 12 cases (30%). Conclusions: Mediastinum is a small narrow limited area in central region of thoracic cavity but it houses a broad array of lesions. Acquaintance regarding the lesions and the topographical distribution helps in the diagnosis of the case. Clinical and imaging features both are very much essential along with histopathology and immunohistochemistry to confirm the diagnosis.
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...
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
Primary Mediastinal Cysts and Tumours: A 5-Year Single Centre Experience
The Indian Journal of Chest Diseases and Allied Sciences
Background. Primary mediastinal lesions pose a diagnostic and management challenge and the distribution of these lesions vary depending upon the population being studied and the type of the health-care facility. Methods. A prospective, observational study of consecutive patients presenting for the evaluation of widened mediastinum on the chest radiograph was conducted during the period of January 2012 to January 2016. Patients with primary oesophageal, cardiac, pulmonary masses extending into the mediastinum, metastatic disease, infection (tuberculosis, fungal infections) and sarcoidosis were excluded. results. We studied 89 histopathological proven cases with primary mediastinal lesions; their mean age was 37.5±20.3 years; there were 50 (56.2%) males. There were 52 (58.4%) benign and 37 (41.6%) malignant lesions. In adults, 39/70 (55.7%) of masses were in the anterior, 11.4% (8/70) in the middle, 10% (7/70) in the posterior and 22.9% (16/70) were in multiple compartments of the mediastinum. In children, 36.8% (7/19) of the masses were in the middle, 31.6% (6/19) in anterior, 21.1% (4/19) in multiple compartment and 10.5% (2/19) in the posterior mediastinum. Lymphomas were the most common lesion 34.8% followed by thymic lesions 26.9%. conclusion. Most of the primary mediastinal lesions could be diagnosed by image guided fiberoptic needle aspiration cytology/ core biopsy. [indian j chest dis allied sci 2019;61:75-81]
Evaluation of 95 Cases with Mediastinal Tumors
journal of cardio-thoracic medicine, 2015
Introduction:Mediastinum contains different vital structures that are located in the anterior and middle or posterior compartments. Various types of mediastinal masses or tumors can be seen in the mediastinum. Materials and Methods:This case series study was performed on 95 patients who had referred to Mashhad University of Medical Sciences between 1990 and 2010 were reviewed. The Inclusion criteria were as follows: Having primary mediastinal masses; Exact tissue pathology; Having received suitable treatment as well as having completed a 3-year follow-up after surgery; The major variables were age, sex, clinical symptoms, mass location, diagnostic procedures, imaging studies, tissue pathology, postoperative complications, mortality and a long-term survival. The patients were followed up for 3 years after the surgery. Results:Ninety-five patients enrolled in the study with M/F=51/44 and the mean age of 35.4+16.52 years. Moreover, anterior mediastinum was the compartment mostly involv...
European Journal of Radiology, 2006
Objective: To describe the computed tomography (CT) features at diagnosis and after treatment of adenocarcinoma of unknown primary (ACUP) mimicking lymphoma of the mediastinum. Methods: Fifteen patients with pathologically proven ACUP and with primarily mediastinal involvement were initially referred to the Hematologic Department of our institution with a suspected diagnosis of lymphoma, and accounted for our study population. Presenting symptoms and baseline biological values were analyzed. All thoraco-abdominal CT studies were reviewed for the location and size of the mediastinal involvement and associated findings. Follow-up chest CT was performed in 14 patients after radiotherapy, chemotherapy or surgical treatment. Results: The most frequent CT feature was a large anterior and middle mediastinal mass (67%), with no calcification. Associated findings included the presence of lung nodules (40%), compression of large mediastinal vessels (33%) and pleural effusion (27%). Follow-up CT, performed in 14 cases, suggested partial or complete responses in 7 patients (50%) 4 weeks after the treatment onset. Conclusions: Mediastinal ACUP is a differential diagnosis of large mediastinal masses and is frequently associated with lung nodules and mediastinal vascular compression.
Chest, 2005
Tumors of the mediastinum are rare in pediatrics but may present in dramatic fashion. Respiratory symptoms such as cough, stridor, and wheezing are present in more than 60% of patients on presentation. A small but significant subset of patients will present with respiratory failure, superior vena cava syndrome, or other immediately life-threatening complaints. Greater than 50% of these masses are malignant, but even nonmalignant tumors can obstruct vital structures and present in a critical fashion. This review seeks to explain the most common mediastinal tumors in childhood and presents a reasonable algorithm for initial workup and treatment by the primary care or emergency department physician. To optimize outcome, these children are best served by a tertiary hospital where the availability of pediatric medical and surgical subspecialists and potential life-saving interventions are possible.