A diagnostic approach to the mediastinal masses (original) (raw)
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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.
National Journal of Medical Research, 2019
Introduction: The studies are not limited to xrays only in this modern radiological era. Since xrays have their own limitations, CT study has made things easier and handy. CT is very much useful in detailing the pathologies of mediastinal lesions. The advent of contrast in CT revelutionizes the evaluation of Mediastinal pathologies. CT also helps in studying in characteristics and nature of masses with involvement of adjacent structures. Additional role of CT scan is to take biopsy of mass lesions and then correlate the CT diagnosis with histopathological diagnosis Material and methods:All the Patients referred in dept of radiodiagnosis, govt medical college and new civil hospital, Surat for clinically suspected mediastinal pathologies and suspected mediastinal lesions on chest X-ray undergone plane or contrast enhanced computed tomography scan (CECT) or both after proper counselling about the procedure and after taking the written consent. Prospective study of all 40 patients done from October 2017 to august 2018 and CT findings were correlated with histopathological diagnosis. Results: In our study, anterior mediastinum was the most commonly involved compartment, followed by superior mediastinum, posterior mediastinum and middle mediastinum. Lymphoma and thymic lesions are most common lesions in anterior and superior mediastinum. Teratoma and metastatic lymphadenopathy in middle mediastinum and neurogenic tumour like schwannoma in posterior mediastinum. Out of 38 patients who undergone biopsy, histopathology report of 35 patients indicates same diagnosis as indicated by CECT (diagnostic accuracy 87.5%). Conclusion: From the above results, we conclude that computed tomography definitely has a major role to play in evaluation of a mediastinal mass regarding the compartmental distribution, mass effect and provisional diagnosis which was correlated with histopathological diagnosis.
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.
Thoracic Radiology
The radiologic evaluation of mediastinal masses is complex and requires a thorough knowledge of the anatomy and compartments of the mediastinum. Although in most cases the diagnosis of mediastinal masses is incidental, especially in the anterior mediastinum, whenever a clinical suspicion exists a standard CXR still remains the first imaging modality used. It allows to evaluate any deformation of the mediastinal profile and displacement of the normal anatomical structures. In some cases, a chest X-ray permits to characterize the location and type of mediastinal lesions; however a CT scan is deemed necessary for significant radiographic alterations.
A case series of mediastinal masses
Annals of Tropical Medicine and Public Health, 2021
Introduction: The majority of mediastinal masses are discovered incidentally. At least half of all mediastinal masses are asymptomatic and detected by chest radiography performed for unrelated reasons. Primary lesions of the mediastinum are less common than lesions that secondarily involve the mediastinum.This case series discuss and highlight the varied presentations, different diagnostic modalities available in establishing the diagnosis of mediastinal masses. The importance and the role of performing immunohistochemistry staining in establishment of final diagnosis and planning of management are also highlighted.
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...
Journal of Evidence Based Medicine and Healthcare
BACKGROUND Mediastinal masses, an enigma to surgical pathologist are among the most complicated lesions explored and relatively inaccessible. They often connote a process with mass effect presenting with superior mediastinal syndrome. This is a challenging area faced by surgical pathologist as varied lesions are found here and often biopsies obtained are tiny and crushed. Appropriate therapy of various mediastinal tumours differs considerably and may significantly impact survival. We wanted to evaluate the various lesions in different compartments of mediastinum and categorise them according to anatomical location, and histopathology. METHODS Patients with mediastinal masses attending outpatient department were selected, history taken and relevant investigations done with radiological evaluation for proper anatomical location of lesion. Histopathological study done on tissues obtained by ultrasound / CT guided biopsy, open surgical biopsy were categorized according to histologic typ...
SPECTRUM OF CT FINDINGS IN POSTERIOR MEDIASTINAL MASSES
Mediastinal masses can be encountered on imaging in many patients whether symptomatic or asymptomatic. Location and characterization of lesion is important for the differential diagnosis of mass. Computed tomography is the modality of choice for the evaluation of mediastinal masses. In this article, we discuss various posterior mediastinal masses and identify their origin and cause.
Mediastinal masses - the bad, the ugly and the unusual!
2007
Background: Differential diagnosis of mediastinal masses is wide and management of individual cases can be challenging. In addition to common malignancies e.g. lymphomas and thymomas. Many other benign and malignant conditions can present with mediastinal masses. Patients and Methods: We describe five patients with a diagnosis of mediastinal mass. We wish to showcase the range of diagnosis possible in these situations. This is followed by a brief discussion on the general approach to such cases. Conclusion: A good history, detailed careful clinical examination, judicious use of imaging and investigations e.g. blood counts and tumour makers can give a vital clue to the diagnosis of mediastinal mass.
CT Evaluation of Mediastinal Masses
Journal of Evidence Based Medicine and Healthcare
BACKGROUND The mediastinum is demarcated by the pleural cavities laterally, the thoracic inlet superiorly and the diaphragm inferiorly. It is further divided into anterior, middle and posterior compartments by many anatomists. 1 CT imaging allows early diagnosis and more specific characterization of anterior mediastinal masses than is possible with plain film radiographs. This study describes state-of-the-art CT imaging of the mediastinum. 1 Detection, diagnosis, staging, and follow-up of anterior mediastinal masses is important and has been significantly improved with CT imaging.