mediastinal lesion

mediastinal lesion

Any mass, benign or malignant, infectious or reactive, that is found in the mediastinum.

Aetiology
▪ Non-neoplastic.
▪ Developmental:
   – Cysts;
   – Tissue in an abnormal location.
▪ Inflammatory/fibrosing conditions
▪ Thymic hyperplasia.
▪ Neoplastic.
▪ Thymic tumours.
▪ Lymphomas:
   – Hodgkin lymphoma;
   – Primary DLBC lymphoma;
   – Lymphoblastic lymphoma.
▪ Germ cell tumours.
▪ Neurogenic tumours:
   – Posterior mediastinum—sympathetic chain and nerve roots.
▪ Sympathetic nervous system:
   – Neuroblastoma;
   – Ganglioneuroblastoma;
   – Ganglioneuroma.
▪ Peripheral nerve sheath tumours:
   – Schwannoma;
   – Neurofibroma;
   – MPNST—De novo, von Recklinghausens, post-radiotherapy.
▪ Soft tissue tumours: 
   – Vascular—Lymphangioma, haemangioma, angisarcoma;
   – Fat—Lipoma, lipoblastoma, thymolipoma, liposarcoma;
   – Smooth muscle—Leiomyoma, leiomyosarcoma
   – Bone—Chondroma, chondrosarcoma;
   – Other—Solitary fibrous tumour (benign or malignant), mesothelioma.
▪ Ectopic tissue:
   – Thyroid lesions;
   – Parathyroid lesions.
▪ Paraganglioma.
▪ Oesophageal.
▪ Metastatic tumours (carcinoma, etc.).
▪ Others:
   – Meningioma;
   – Chordoma;
   – Myxoma;
   – Granular cell tumour;
   – Amyloid;
   – Langerhans cell histiocytosis.
References in periodicals archive ?
In our case, the patient had fallen from a height of 2 m; he presented with right chest pain, and chest radiography revealed the posterior mediastinal lesion.
In this study, 25 patients with an anterior mediastinal lesion underwent CT perfusion imaging from January 2015 to February 2016.
However, recently Inoue et al (64) reported a patient with sclerosing mediastinitis who had elevated serum IgG4 and increased numbers of IgG4-positive plasma cells in the mediastinal lesion.
Magnetic resonance (MR) imaging demonstrated that the neck mass detected on sonography was a homogenous anterior mediastinal lesion extending to the neck, compatible with hyperplasia of the thymus (Fig.
Key Words: superior pericardial recess, mediastinal lesion, computed tomography
6) The case of our patient 1 illustrates how a mediastinal lesion may mimic a thyroid mass on physical examination but be readily apparent as such on CT.
Finally, the cervicothoracic sign (Figure 6) is used to determine the location of a mediastinal lesion in the upper chest.
Ectopic thyroid tissue: an unusual differential diagnosis of space-occupying mediastinal lesions.
However, for descriptive purpose seven lesions that have both anterior and middle mediastinal component were considered in anterior mediastinal lesions.
7,8) Whenever a mediastinal mass is suspected, a CT scan should be done to delineate posterior mediastinal lesions and to distinguish between the esophageal or bronchogenic origin of the cyst.
This 13-chapter guide outlines the clinical, technical, and pathological aspects of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to diagnose mediastinal lesions.
ConclusionAs surgical excision has good results such patients should be identified early clinically and radiologically by keeping strong suspicion of late presentation of congenital mediastinal lesions thus preventing morbid complications.

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