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Surgical Pathology Clinics Jun 2024Primary sarcoma of the lung and mediastinum is rare. The diagnosis requires careful exclusion of sarcomatoid carcinoma, sarcomatoid mesothelioma, and metastases from... (Review)
Review
Primary sarcoma of the lung and mediastinum is rare. The diagnosis requires careful exclusion of sarcomatoid carcinoma, sarcomatoid mesothelioma, and metastases from extra-thoracic sites. This review summarizes the key morphologic, immunohistochemical, and molecular characteristics of sarcomas that are encountered in the lung and mediastinum. The tumor types discussed are synovial sarcoma, well-differentiated/dedifferentiated liposarcoma, myxoid pleomorphic liposarcoma, intimal sarcoma of the pulmonary artery, inflammatory myofibroblastic tumor, epithelioid hemangioendothelioma, primary pulmonary myxoid sarcoma, malignant peripheral nerve sheath tumor, Ewing sarcoma, and CIC-rearranged sarcoma. Relevant differential diagnoses are also addressed.
Topics: Humans; Mediastinal Neoplasms; Lung Neoplasms; Sarcoma; Diagnosis, Differential; Biomarkers, Tumor
PubMed: 38692808
DOI: 10.1016/j.path.2023.11.008 -
Seminars in Diagnostic Pathology Jul 2020Neurogenic tumors represent a broad ill-defined category of neoplasms that includes tumors of Schwann cell and/or neuroblastic derivation, as well as neoplasms that... (Review)
Review
Neurogenic tumors represent a broad ill-defined category of neoplasms that includes tumors of Schwann cell and/or neuroblastic derivation, as well as neoplasms that typically develop in the central nervous system, but rarely present in ectopic sites including the mediastinum. Neurogenic tumors may occur at many different anatomic sites, but the mediastinum represents a uniquely challenging site given the complex anatomy. Additionally, some of these neoplasms may present with multicentric involvement in the context of genetic syndromes, including NF1, NF2 and schwanomatosis. Most of these develop in posterior structures, often in association with paraspinal structures. Fine needle biopsy/small biopsies play an important role in the diagnosis of these neoplasms, given its record of safety and the increased applicability of ancillary testing to these smaller samples at the present time. In this review we focus on the major categories of neurogenic tumors that may be encountered in the mediastinum, including schwannoma, neurofibroma, malignant peripheral nerve sheath tumors, ganglioneuroma and ganglioneuroblastoma, as well as rarer members of this category. We discuss diagnostic approaches applicable to small cytologic and tissue samples and relevant differential diagnoses.
Topics: Humans; Mediastinal Neoplasms; Neoplasms, Nerve Tissue
PubMed: 32448592
DOI: 10.1053/j.semdp.2020.04.004 -
Radiologie (Heidelberg, Germany) Mar 2023Lesions of the paravertebral mediastinum are rare, and knowledge of possible differential diagnoses is essential for clinical practice. (Review)
Review
BACKGROUND
Lesions of the paravertebral mediastinum are rare, and knowledge of possible differential diagnoses is essential for clinical practice.
OBJECTIVE/METHODS
To review common lesions of the paravertebral mediastinum.
RESULTS
The paravertebral mediastinum mainly includes fatty tissue and neurogenic structures. Imaging is commonly performed using computed tomography (CT) and magnetic resonance imaging (MRI). Neurogenic tumors are the most common lesions of the paravertebral mediastinum. Other pathologies include extramedullary hematopoiesis, lipomatous, lymphogenic, inflammatory, and cystic lesions. Moreover, also diaphragmatic hernias, vascular and esophageal pathologies may be found in the paravertebral mediastinum.
Topics: Humans; Mediastinum; Mediastinal Neoplasms; Tomography, X-Ray Computed; Magnetic Resonance Imaging; Lipoma
PubMed: 36627368
DOI: 10.1007/s00117-022-01109-0 -
Archives of Disease in Childhood.... Dec 2019To present a structured approach to the management of a child with a mediastinal mass presenting to the emergency department. To raise awareness of presenting features... (Review)
Review
OBJECTIVES
To present a structured approach to the management of a child with a mediastinal mass presenting to the emergency department. To raise awareness of presenting features of less-obvious mediastinal masses and to encourage consideration of mediastinal masses in differential diagnoses.
METHODS
Review of the relevant literature and review of London Paediatric Cancer Network supportive guidelines and subsequent description of the approach to a child presenting with features suggestive of a mediastinal mass.
CONCLUSIONS
A systematic approach to history taking, clinical examination and investigation of a child presenting with a mediastinal mass will assist in the safe and timely management of children presenting when they are critically unwell. Anticipation of potential management complications and early transfer for ongoing management will improve patient outcomes and minimise morbidity.
Topics: Airway Management; Diagnosis, Differential; Humans; Mediastinal Neoplasms; Mediastinum; Medical History Taking; Physical Examination
PubMed: 31048342
DOI: 10.1136/archdischild-2018-315269 -
Radiologic Clinics of North America Mar 2021The visceral mediastinum contains important vascular and non-vascular structures including the heart, great vessels, lymph nodes, and portions of the esophagus and... (Review)
Review
The visceral mediastinum contains important vascular and non-vascular structures including the heart, great vessels, lymph nodes, and portions of the esophagus and trachea. Multiple imaging modalities, including chest radiography, computed tomography, MR imaging, and nuclear medicine studies, can be used to detect, diagnose, and characterize masses in this compartment. Lymphadenopathy is the most common process involving the visceral mediastinum and can be seen with a wide variety of diseases. Less commonly seen entities include foregut duplication cysts, neoplasms and other lesions arising from the trachea and esophagus, paragangliomas as well as other mesenchymal tumors.
Topics: Diagnostic Imaging; Humans; Mediastinal Neoplasms; Mediastinum
PubMed: 33551081
DOI: 10.1016/j.rcl.2020.11.004 -
Paediatric Anaesthesia Jan 2022Children with an anterior mediastinal mass may have cardiopulmonary compromise that can be exacerbated under general anesthesia. Signs and symptoms such as cough,... (Review)
Review
Children with an anterior mediastinal mass may have cardiopulmonary compromise that can be exacerbated under general anesthesia. Signs and symptoms such as cough, shortness of breath, stridor, orthopnea, accessory muscle use, a history of respiratory arrest, and the presence of a pleural effusion and upper body edema are predictive of perioperative complications. A larger mediastinal mass on imaging is predictive of perioperative complications. Risk stratification of patients, together with an individualized plan, will best guide operative management for patients with an anterior mediastinal mass. General anesthesia (GA) should be avoided if possible, but a spontaneous breathing technique is recommended if GA is required.
Topics: Anesthesia, General; Anesthesiology; Child; Humans; Mediastinal Neoplasms; Pleural Effusion
PubMed: 34714957
DOI: 10.1111/pan.14319 -
Radiologie (Heidelberg, Germany) Mar 2023Mediastinal masses are a group of heterogenous lesions which may be a coincidental finding or present with symptoms. More than half of mediastinal lesions are located... (Review)
Review
CLINICAL/METHODOLOGICAL ISSUE
Mediastinal masses are a group of heterogenous lesions which may be a coincidental finding or present with symptoms. More than half of mediastinal lesions are located in the prevascular mediastinum. As these tumors are not often encountered in clinical routine, making a diagnosis with a high degree of confidence may seem challenging.
STANDARD RADIOLOGICAL METHODS
The latest computed tomography (CT)-based classification of the mediastinal compartments by the International Thymic Malignancy Interest Group (ITMIG) moves away from earlier radiograph-based classification systems and helps to reliably classify tumors based on location, although in some cases the lesion can occupy more than one compartment.
PERFORMANCE
Radiology plays an important role in the evaluation of anterior mediastinal lesions. Although in some cases imaging features alone allow a diagnosis to be made; in other cases knowledge of important radiological features and their analysis in the context of patient factors like age and duration of symptoms can help to narrow down the differential diagnosis, avoid unnecessary workup, and guide further steps.
PRACTICAL RECOMMENDATIONS
Computed tomography (CT) is central for the characterization of mediastinal masses in clinical routine. In some situations, like in the case of thymic cysts or thymic hyperplasia, magnetic resonance imaging (MRI) can be used as a noninvasive problem-solving tool.
Topics: Humans; Mediastinum; Mediastinal Neoplasms; Thymus Neoplasms; Tomography, X-Ray Computed; Mediastinal Cyst
PubMed: 36797329
DOI: 10.1007/s00117-023-01125-8 -
Journal of Basic and Clinical... Mar 2023Sarcoma is defined as a tumor located in the thoracic cavity. However, sarcoma can occur on every side of the body. Synovial sarcoma is a rare soft tissue tumor... (Review)
Review
Sarcoma is defined as a tumor located in the thoracic cavity. However, sarcoma can occur on every side of the body. Synovial sarcoma is a rare soft tissue tumor originating from pluripotent with a high malignancy rate. The most common predilection of synovial sarcoma is in the joints. Primary synovial sarcoma of the lung and mediastinum are rare tumors and generally malignant. There are only a few cases have been reported. Definite diagnosis is made by histopathological, immunohistochemistry, and cytogenetic examination. The management strategy for synovial sarcoma requires multimodality treatment with surgery, chemotherapy, and radiotherapy. However, effective and relatively non-toxic therapy for primary synovial sarcoma is still developed. The five years life expectancy is higher if the patient received adjuvant radiotherapy and/or chemotherapy after surgery.
Topics: Humans; Sarcoma, Synovial; Mediastinal Neoplasms; Mediastinum; Lung; Lung Neoplasms
PubMed: 36800987
DOI: 10.1515/jbcpp-2022-0286 -
Advances in Anatomic Pathology Sep 2021Mesenchymal tumors of the mediastinum are a heterogenous group of rare tumors with divergent lineages. Mediastinal mesenchymal tumors are diagnostically challenging due... (Review)
Review
Mesenchymal tumors of the mediastinum are a heterogenous group of rare tumors with divergent lineages. Mediastinal mesenchymal tumors are diagnostically challenging due to their diversity and morphologic overlap with nonmesenchymal lesions arising in the mediastinum. Accurate histologic diagnosis is critical for appropriate patient management and prognostication. Many mediastinal mesenchymal tumors affect distinct age groups or occur at specific mediastinal compartments. Neurogenic tumors, liposarcoma, solitary fibrous tumor, and synovial sarcoma are common mesenchymal tumors in the mediastinum. Herein, we provide an update on the diagnostic approach to mediastinal mesenchymal tumors and a review of the histologic features and differential diagnosis of common benign and malignant mesenchymal tumors of the mediastinum.
Topics: Humans; Liposarcoma; Mediastinal Neoplasms; Mediastinum
PubMed: 34050062
DOI: 10.1097/PAP.0000000000000306 -
Kyobu Geka. the Japanese Journal of... Sep 2022Mediastinal tumors rarely lead to acute symptomatic manifestations due to spontaneous rupture and perforation, intra-tumoral hemorrhage, and bacterial contamination....
Mediastinal tumors rarely lead to acute symptomatic manifestations due to spontaneous rupture and perforation, intra-tumoral hemorrhage, and bacterial contamination. Moreover, giant mediastinal tumors can compress and infiltrate surrounding mediastinal structures, such as the trachea, bronchus, cardiac sac, and superior vena cava, at the first visit. In addition, mediastinal mature teratomas include various ectopic tissues such as digestive glands and sebaceous glands that can cause specific pathological conditions. To address and properly manage patients with these rare conditions, prior learning must be emphasized to facilitate in clinical decision-making. In this article, we classified four pathological conditions of emergency due to mediastinal tumors. These include the clinical conditions resulting from the compression of anatomical structures by the tumor, those resulting from infiltration and extension into the surrounding mediastinal structures by the tumor, the specific conditions attributable to mature teratomas, and the occurrence of hemothorax due to spontaneous rupturing of the tumor. Based on the review of our cases and other recently reported cases, we summarize and discuss practical pitfalls and pearls in the emergency surgical management of these rare but life-threatening clinical situations.
Topics: Humans; Mediastinal Neoplasms; Mediastinum; Rupture, Spontaneous; Teratoma; Vena Cava, Superior
PubMed: 36155587
DOI: No ID Found