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==Differential diagnosis of mediastinal mass== | ==Differential diagnosis of mediastinal mass== | ||
Wide variety of medical conditions can present as a mediastinal mass on radiological | Wide variety of medical conditions can present as a mediastinal mass on [[Radiology|radiological imaging]]. | ||
* Mediastinal mass may cause obstruction, entrapment or infiltration of other mediastinal organs such as: [[Trachea]], [[Bronchus|bronchi]], [[esophagus]], [[aorta]], [[SVC|superior vena cava (SVC)]] or [[heart]].<ref name="pmid27698718">{{cite journal |vauthors=Zardi EM, Pipita ME, Afeltra A |title=Mediastinal syndrome: A report of three cases |journal=Exp Ther Med |volume=12 |issue=4 |pages=2237–2240 |date=October 2016 |pmid=27698718 |pmc=5038184 |doi=10.3892/etm.2016.3596 |url=}}</ref> | * Mediastinal mass may cause [[obstruction]], [[entrapment]] or [[Infiltration (medical)|infiltration]] of other [[Mediastinum|mediastinal organs]] such as: [[Trachea]], [[Bronchus|bronchi]], [[esophagus]], [[aorta]], [[SVC|superior vena cava (SVC)]] or [[heart]].<ref name="pmid27698718">{{cite journal |vauthors=Zardi EM, Pipita ME, Afeltra A |title=Mediastinal syndrome: A report of three cases |journal=Exp Ther Med |volume=12 |issue=4 |pages=2237–2240 |date=October 2016 |pmid=27698718 |pmc=5038184 |doi=10.3892/etm.2016.3596 |url=}}</ref> | ||
* Disorder caused by any kind of [[mediastinal mass]] is collectively known as: | * Disorder caused by any kind of [[mediastinal mass]] is collectively known as: [[Mediastinal syndromes]] | ||
* '''Mediastinal syndrome''' includes: | |||
** Compression of the [[trachea]]: [[Dyspnea]] and [[respiratory insufficiency]] | ** Compression of the [[trachea]]: [[Dyspnea]] and [[respiratory insufficiency]]. | ||
** Compression of the [[esophagus]]: [[Dysphagia]] | ** Compression of the [[esophagus]]: [[Dysphagia]]. | ||
*** | ** Compression of [[SVC]] causes [[superior vena cava syndrome]]: [[Vein]] distention, [[edema]] of the face or [[Upper limb|upper extremities]] and a positive [[Pemberton's sign]]. | ||
*** [[Superior vena cava syndrome]] is the most severe [[Complication (medicine)|complication]] of [[mediastinal syndrome]] and a [[medical emergency]]. | |||
* | |||
{| | {| | ||
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''<big>Class</big>''' | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''<big>Class</big>''' |
Revision as of 18:35, 6 February 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Trusha Tank, M.D.[3]
Overview
Differential diagnosis of mediastinal mass
Wide variety of medical conditions can present as a mediastinal mass on radiological imaging.
- Mediastinal mass may cause obstruction, entrapment or infiltration of other mediastinal organs such as: Trachea, bronchi, esophagus, aorta, superior vena cava (SVC) or heart.[1]
- Disorder caused by any kind of mediastinal mass is collectively known as: Mediastinal syndromes
- Mediastinal syndrome includes:
- Compression of the trachea: Dyspnea and respiratory insufficiency.
- Compression of the esophagus: Dysphagia.
- Compression of SVC causes superior vena cava syndrome: Vein distention, edema of the face or upper extremities and a positive Pemberton's sign.
- Superior vena cava syndrome is the most severe complication of mediastinal syndrome and a medical emergency.
Class | Disease | Symptoms | Mediastinal syndrome | Etiology | Gold standard | Image | Additional findings |
---|---|---|---|---|---|---|---|
Anterior mediastinal mass | |||||||
Tumors | Thymoma |
|
|
Biopsy:
|
Associated condition
| ||
Fatty mass |
|
|
MRI:
|
Fatty mass can be:
| |||
Non-Hodgkin lymphoma |
|
(HIV, Hep C, HTLV-1, EBV, HHV-8, H. pylori, psittacosis, Campylobacter jejuni)
(pesticides, methotrexate, TNF inhibitors, trichloroethylene)
|
Excisional lymph node biopsy with immunohistochemical study
|
| |||
Teratoma | Benign
Malignant |
|
Chest CT scan:
|
N/A | |||
Thyroid disease | Thyroid cancer[2] |
|
|
US guided biopsy: | TFT
| ||
Goiter |
|
Radioactive iodine scan:
|
Hyperavtive gland (hyperthyroid):
Hypoactive gland (hypothyroid):
Normal functioning gland (euthyroid):
| ||||
Class | Disease | Sign/Symptoms | Mediastinal syndrome | Causes/Risk factors | Gold standard | Image | Additional findings |
Middle mediastinal mass | |||||||
CVS disease | Pericardial effusion |
|
|
||||
Aortic dissection[2] | |||||||
Superior vena cava obstruction[2] | |||||||
Partial anomalous pulmonary venous connection[2] | |||||||
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 | ||||||
Class | Disease | Sign/Symptoms | Mediastinal syndrome | Causes/Risk factors | Gold standard | Image | Additional findings |
Posterior mediastinal mass | |||||||
CNS disease | Meningocele[2] | ||||||
Neurilemmoma[2] |
- Superior vena cava obstruction
- Partial anomalous pulmonary venous connection
- Esophageal achalasia
- Esophageal cancer
- Esophageal rupture
- Hiatus hernia
- Hilar lymphadenopathy
- Pneumomediastinum
- Sarcoidosis
- Lymphoma
- Neurilemmoma
- Non-Hodgkin lymphoma
- Teratoma
- Thymoma
References
- ↑ Zardi EM, Pipita ME, Afeltra A (October 2016). "Mediastinal syndrome: A report of three cases". Exp Ther Med. 12 (4): 2237–2240. doi:10.3892/etm.2016.3596. PMC 5038184. PMID 27698718.
- ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L (February 2013). "A diagnostic approach to the mediastinal masses". Insights Imaging. 4 (1): 29–52. doi:10.1007/s13244-012-0201-0. PMID 23225215.
- ↑ Molinari F, Bankier AA, Eisenberg RL (November 2011). "Fat-containing lesions in adult thoracic imaging". AJR Am J Roentgenol. 197 (5): W795–813. doi:10.2214/AJR.11.6932. PMID 22021525.
- ↑ Sandlund JT (2015). "Non-Hodgkin Lymphoma in Children". Curr Hematol Malig Rep. 10 (3): 237–43. doi:10.1007/s11899-015-0277-y. PMID 26174528.
- ↑ Armitage JO, Gascoyne RD, Lunning MA, Cavalli F (2017). "Non-Hodgkin lymphoma". Lancet. 390 (10091): 298–310. doi:10.1016/S0140-6736(16)32407-2. PMID 28153383.
- ↑ Yalagachin GH (June 2013). "Anterior mediastinal teratoma- a case report with review of literature". Indian J Surg. 75 (Suppl 1): 182–4. doi:10.1007/s12262-012-0569-6. PMID 24426558.
- ↑ No TH, Seol SH, Seo GW, Kim DI, Yang SY, Jeong CH, Hwang YH, Kim JY (September 2015). "Benign Mature Teratoma in Anterior Mediastinum". J Clin Med Res. 7 (9): 726–8. doi:10.14740/jocmr2270w. PMC 4522994. PMID 26251691.
- ↑ "Benign thyroid enlargement (non-toxic multinodular goiter): Overview".
- ↑ Vanneman MW, Fikry K, Quraishi SA, Schoenfeld W (August 2015). "A Young Man with a Mediastinal Mass and Sudden Cardiac Arrest". Ann Am Thorac Soc. 12 (8): 1235–9. doi:10.1513/AnnalsATS.201504-212CC. PMID 26317273.