-
Journal of Thoracic Oncology : Official... Sep 2014Anterior mediastinal masses are relatively uncommon, include a wide variety of entities, and often pose a diagnostic challenge for clinicians. In this article, available... (Review)
Review
Anterior mediastinal masses are relatively uncommon, include a wide variety of entities, and often pose a diagnostic challenge for clinicians. In this article, available data is assembled in a clinically oriented manner to develop a structured approach to evaluation of these patients. Attention to age and gender, combined with identification of certain radiographic and clinical characteristics, allows a presumptive diagnosis to be established in most patients. This structure efficiently guides what additional workup is needed.
Topics: Humans; Magnetic Resonance Imaging; Mediastinal Neoplasms; Mediastinum; Radiography
PubMed: 25396306
DOI: 10.1097/JTO.0000000000000294 -
Seminars in Diagnostic Pathology Mar 2022Acute mediastinitis is a rare infection that carries high morbidity and mortality. They are complications seen most often with deep sternal wound infections from... (Review)
Review
Acute mediastinitis is a rare infection that carries high morbidity and mortality. They are complications seen most often with deep sternal wound infections from surgeries with median sternotomies, oropharyngeal and odontogenic infections and esophageal perforations. These conditions should be promptly recognized and treated. Mediastinal granulomas are focal, mass-like lesions commonly resulting from prior granulomatous infections. They are regarded as benign, self-resolving lesions however can cause complications by compression of adjacent mediastinal structures. Chronic fibrosing mediastinitis is a rare, diffuse fibroinflammatory process most often seen with granulomatous infections and carries a worse prognosis than mediastinal granulomas especially when adjacent mediastinal structures are compromised. In this review, we discuss the epidemiology, etiology, clinical presentation, treatment and prognosis of acute mediastinitis, mediastinal granulomas, and chronic fibrosing mediastinitis.
Topics: Acute Disease; Granuloma; Humans; Mediastinitis; Mediastinum; Sclerosis
PubMed: 34176697
DOI: 10.1053/j.semdp.2021.06.008 -
The Netherlands Journal of Medicine Nov 2005
Topics: Humans; Male; Mediastinum; Middle Aged; Pancreatic Pseudocyst; Radiography
PubMed: 16301762
DOI: No ID Found -
Pediatric Radiology Sep 2022Mediastinal masses are categorized based on the International Thymic Malignancy Interest Group (ITMIG) classification into prevascular, visceral and paravertebral... (Review)
Review
Mediastinal masses are categorized based on the International Thymic Malignancy Interest Group (ITMIG) classification into prevascular, visceral and paravertebral compartments. The schema is based on cross-sectional imaging, mainly CT, and helps with generating a differential diagnosis based on location of the mass. Up to half of all pediatric mediastinal tumors are malignant. In this review we describe mediastinal masses that are relevant to the pediatric population, as well as the role of MR imaging of mediastinal masses and its advantages.
Topics: Child; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Mediastinal Neoplasms; Mediastinum; Tomography, X-Ray Computed
PubMed: 35674800
DOI: 10.1007/s00247-022-05409-4 -
Radiographics : a Review Publication of... 2017Division of the mediastinum into specific compartments is beneficial for a number of reasons, including generation of a focused differential diagnosis for mediastinal... (Review)
Review
Division of the mediastinum into specific compartments is beneficial for a number of reasons, including generation of a focused differential diagnosis for mediastinal masses identified on imaging examinations, assistance in planning for biopsies and surgical procedures, and facilitation of communication between clinicians in a multidisciplinary setting. Several classification schemes for the mediastinum have been created and used to varying degrees in clinical practice. Most radiology classifications have been based on arbitrary landmarks outlined on the lateral chest radiograph. A new scheme based on cross-sectional imaging, principally multidetector computed tomography (CT), has been developed by the International Thymic Malignancy Interest Group (ITMIG) and accepted as a new standard. This clinical division scheme defines unique prevascular, visceral, and paravertebral compartments based on boundaries delineated by specific anatomic structures at multidetector CT. This new definition plays an important role in identification and characterization of mediastinal abnormalities, which, although uncommon and encompassing a wide variety of entities, can often be diagnosed with confidence based on location and imaging features alone. In other scenarios, a diagnosis may be suggested when radiologic features are combined with specific clinical information. In this article, the authors present the new multidetector CT-based classification of mediastinal compartments introduced by ITMIG and a structured approach to imaging evaluation of mediastinal abnormalities. RSNA, 2017.
Topics: Diagnosis, Differential; Humans; Mediastinal Neoplasms; Mediastinum; Multidetector Computed Tomography; Thymus Neoplasms
PubMed: 28129068
DOI: 10.1148/rg.2017160095 -
The Journal of Thoracic and... Oct 2016
Topics: Humans; Mediastinal Neoplasms; Mediastinum
PubMed: 27474176
DOI: 10.1016/j.jtcvs.2016.06.001 -
Anesthesiology Clinics of North America Sep 2001Anesthesia for patients with mediastinal masses carries a significant risk for fatal or near-fatal cardiorespiratory events. Careful history taking and thorough... (Review)
Review
Anesthesia for patients with mediastinal masses carries a significant risk for fatal or near-fatal cardiorespiratory events. Careful history taking and thorough preoperative investigation, including CT, identify most susceptible patients. Preoperative fiberoptic bronchoscopy performed by or involving the anesthesiologist is invaluable for determining the plan for intubation and ventilation. A coordinated approach involving anesthesiologists and surgeons is essential.
Topics: Anesthesia; Humans; Intubation, Intratracheal; Mediastinal Neoplasms; Mediastinum; Preoperative Care; Respiratory Function Tests; Superior Vena Cava Syndrome; Trachea
PubMed: 11571906
DOI: 10.1016/s0889-8537(05)70247-9 -
European Journal of Radiology May 2023Mediastinal masses have various histopathological and radiological findings. Although lymphoma is the most common type of tumor, thymic epithelial and neurogenic tumors... (Review)
Review
PURPOSE
Mediastinal masses have various histopathological and radiological findings. Although lymphoma is the most common type of tumor, thymic epithelial and neurogenic tumors are common in adults and children, respectively, but several other types are difficult to distinguish. No previous review has simply and clearly shown how to differentiate mediastinal masses.
METHOD
We conducted a review of the latest mediastinal classifications and mass differentiation methods, with a focus on neoplastic lesions. Both older and recent studies were searched, and imaging and histopathological findings of mediastinal masses were reviewed. Original simple-to-use differentiation flowcharts are presented.
RESULTS
Assessing localizations and internal characteristics is very important for mediastinal mass differentiation. The mass location and affected organ/tissue should be accurately assessed first, followed by more qualitative diagnosis, and optimization of the treatment strategy. In 2014, the International Thymic Malignancy Interest Group presented a new mediastinal clinical classification. In this classification, mediastinal masses are categorized into three groups according to location: prevascular (anterior)-, visceral (middle)-, and paravertebral (posterior)-compartment masses. Then, the internal characteristics and functional images are evaluated.
CONCLUSIONS
Differentiation of mediastinal masses is very difficult. However, if typical imaging findings and clinical characteristics are combined, reasonable differentiation is possible. In each patient, proper differential diagnosis may contribute to better treatment selection.
Topics: Adult; Child; Humans; Mediastinal Neoplasms; Thymus Neoplasms; Mediastinum; Lymphoma; Thymus Gland
PubMed: 36921376
DOI: 10.1016/j.ejrad.2023.110767 -
Kyobu Geka. the Japanese Journal of... Jun 2020Computed tomography(CT) is indispensable for diagnostic imaging. During preoperative assessment for cardioaortic surgery, a CT examination is performed not only for... (Review)
Review
Computed tomography(CT) is indispensable for diagnostic imaging. During preoperative assessment for cardioaortic surgery, a CT examination is performed not only for diagnostic purposes but also to decide the surgical strategy. In some cases, CT demonstrates a small abnormal mass in the adipose tissue of the anterior mediastinum. Sometimes radiologists diagnose the image and send the diagnostic report to cardiologists or cardiovascular surgeons. However, they tend to limit their focus to their field of specialty. Thus, they might overlook or underestimate an abnormal mass. Anterior mediastinal masses, though small, may include malignant tumors. Thus, we reviewed 12 cases in which anterior mediastinal masses were found on preoperative CT. Two of these patients were finally diagnosed with malignant tumors. We should pay attention to not only cardiovascular assessment but also mediastinal masses on preoperative CT. In some cases, concomitant surgery for cardioaortic disease and an anterior mediastinal tumor is effective.
Topics: Humans; Mediastinal Neoplasms; Mediastinum; Tomography, X-Ray Computed
PubMed: 32475962
DOI: No ID Found -
Journal of Computer Assisted Tomography 2019We set out to evaluate a set of demographic and computed tomography imaging features for diagnosing anterior mediastinal masses.
OBJECTIVE
We set out to evaluate a set of demographic and computed tomography imaging features for diagnosing anterior mediastinal masses.
METHODS
We identified 223 patients with anterior mediastinal masses, which we divided into training and validation sets. One radiologist evaluated computed tomography imaging features on the training set. Then, predictive features were identified, and 3 radiologists evaluated these on the validation set. A naive Bayesian classifier based on the features was compared with the radiologists' first-choice diagnosis.
RESULTS
Internal mammary lymphadenopathy and mediastinal encasement were strongly associated with lymphomas. Low attenuation and midline location were strongly associated with benign lesions, and older age was associated with thymic epithelial neoplasms. The average accuracy of the 3 radiologists' diagnoses was 78%, compared with 71% for the classifier.
CONCLUSIONS
Nine demographic and imaging features were found to be helpful in diagnosing anterior mediastinal masses. By using these features, radiologists can suggest the diagnosis with fair accuracy.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Mediastinal Neoplasms; Mediastinum; Middle Aged; Predictive Value of Tests; Reproducibility of Results; Retrospective Studies; Tomography, X-Ray Computed; Young Adult
PubMed: 30052619
DOI: 10.1097/RCT.0000000000000782