Sandbox:Trusha

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Trusha Tank, M.D.[3]

1. Bowel endometriosis vs Hemorrhoids vs Diverticular diseases vs Anal fissure vs Ulcerative colitis vs Crohn's disease,
2. Superior vena cava obstruction
3. Partial anomalous pulmonary venous connection
4. Esophageal achalasia
5. Esophageal cancer
6. Esophageal rupture
7. Hiatus hernia
8. Hilar lymphadenopathy
9. Pneumomediastinum
10. Sarcoidosis
11. Lymphoma
12. Neurilemmoma
13. Non-Hodgkin lymphoma
14. Teratoma
15. Thymoma

1. Thyroid cancer
2. Goitre
3. Mediastinal germ cell tumor,
4. Mediastinal tumor,
5. Mediastinitis

1. Churg-Strauss syndrome
2. Bronchogenic cyst,
3. Dermoid cyst
4. Anthrax:
5. Tularemia.

Class	Disease	Sign/Symptoms	Risk factors	Gold standard	Image	Additional findings
Anterior mediastinal mass
Tumors	Thymoma	Facial swelling Dysphagia Cough wheezing Chest pain Muscle weakness (MG) Anemia	Human foamy virus Epstein-Barr virus Human T-cell lymphotropic virus MEN 1 syndrome	Biopsy: Epithelial cells Immature lymphocytes Immature T cells		Associated condition NM Myasthenia gravis Neuromyotonia Rippling muscle disease Polymyositis/dermatomyositis Encephalitis (limbic, cortical and brain stem) Intestinal pseudoobstruction Hematological Anemia: pure red cell aplasia, pernicious anemia, hemolytic anemia, aplastic anemia Other isolated cytopenias: eosinophils, basophils neutrophils Immunodeficiencies: hypogammaglobulinemia/- T-cell deficiencies (Good syndrome) Dermatological Pemphigus (foliaceus or paraneoplastic) Lichen planus Alopecia areata Endocrine Addison disease Grave's disease Cushing's disease Hepato-renal Glomerulonephritis Autoimmune hepatitis Systemic Autoimmune Diseases SLE Sjögren's syndrome Systemic sclerosis Graft-versus-host disease
	Fatty mass	Mostly asymptomatic	Steroid use Cushing's syndrome Obeses	MRI: Well-defined encapsulated mas Extensive fat content Small amounts of solid areas Fibrous septa		Fatty mass can be: Lipoma Liposarcoma Thymolipoma
	Non-Hodgkin lymphoma	Painless lymphadenopathy Fever Weight loss and anorexia Night sweats Constant fatigue Itchy skin Cough Shortness of breath Abdominal pain or swelling Constipation Nausea Vomiting Headache Personality changes Seizures	Age (above 60 years) Caucasians > African and Asian Americans Positive family history of first degree relative B-cell activating autoimmune disorders Radiation exposure Infections (HIV, Hep C, HTLV-1, EBV, HHV-8, H. pylori, psittacosis, Campylobacter jejuni) Previous cancer treatment Exposure to chemicals and drugs (pesticides, methotrexate, TNF inhibitors, trichloroethylene) Cigarette smoking for ≥ 40 years BMI ≥30 kg/m2 Diet Hair dyes Breast implants	Excisional lymph node biopsy with immunohistochemical study CD 20+ cells		Anemia: Involvement of bone marrow Autoimmune hemolysis and bleeding. Thrombocytopenia, leukopenia, or pancytopenia Lymphocytosis with malignant cells Thrombocytosis
	Teratoma	Benign Asymptomatic Malignant Cough Dyspnea Chest pain Superior vena cava syndrome Trichoptysis	Benign equal in men and women Malignant more common in men Pediatric population higher risk	Chest CT scan: Location Metastasis Intrinsic structure Soft tissue Fat Calcification		N/A
Thyroid disease	Thyroid cancer	Lump in the neck Dysphonia Dysphagia Dyspnea Lymphadenopathy Cough Sore throat Neck pain	Hx of goiter Family Hx of thyroid disease Female gender Asian race Radiation exposure MEN syndrome	US guided biopsy: Papillary thyroid cancer Follicular thyroid cancer Medullary thyroid cancer Anaplastic thyroid cancer Lymphoma		TFT Elevated T3 Elevated T4 Low TSH
	Goiter	A visible swelling at the base of your neck Tight feeling in throat Cough Hoarseness Dysphagia Dyspnea Fatigue	Iodine deficiency Female gender Age over 50 years Personal or family history Certain medications Immunosuppressants Antiretrovirals Amiodarone Lithium Radiation	Radioactive iodine scan: Nodules Size Nature of the gland:
Middle mediastinal mass
CVS disease	Pericardial effusion
	Aortic dissection
	Superior vena cava obstruction
	Partial anomalous pulmonary venous connection
GI disease	Esophageal achalasia
	Esophageal cancer
	Esophageal rupture
	Hiatus hernia
Pulmonary disease	Hilar lymphadenopathy
	Pneumomediastinum
	Sarcoidosis
Mediastinal tumor	Mediastinal tumor
	Mediastinal germ cell tumor
Infection	Mediastinitis
	Anthrax
	Tularemia
Cystic disease	Dermoid cyst
	Bronchogenic cyst
Chronic inflammatory	Churg-Strauss syndrome
Posterior mediastinal mass
CNS disease	Meningocele
	Neurilemmoma

CT scan showing a smooth anterior mediastinal mass, with a mixed internal density of containing both enhancing soft tissue and cystic areas. The outline of the mass is relatively well defined. No lymphadenopathy, pleural effusion or infiltration. Case courtesy of Dr. Abdallah Al Khateeb (Picture courtesy: Radiopedia)

CT scan showing excessive fatty tissue deposition within the posterior mediastinum with anterior displacement of the esophagus. Case courtesy of Dr. Ahmed Abdrabou (Picture courtesy: [1])