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{{SK}} Mediastinal enlargement; mass in the mediastinum
{{SK}} Mediastinal enlargement; mass in the mediastinum
==Overview==
==Overview==
The [[mediastinum]] is a non-delineated group of structures in the thorax (chest), surrounded by loose connective tissue. Since it is the central compartment of the thoracic cavity, and it contains a lot of important structures, it is the site of involvement of various tumors. Different types of mediastinal masses can be encountered in various imaging techniques causing pressure symptoms or even without causing any symptoms. Mediastinal masses can be differentiated on the basis of location in the mediastinal cavity and/or composition of the mass.
The [[mediastinum]] is a non-delineated group of structures in the thorax (chest), surrounded by loose connective tissue. It is the central compartment of the thoracic cavity. It contains the heart, the great vessels of the heart, esophagus, trachea, thymus, and lymph nodes of the central chest. A wide variety of diseases involving these organs can present as a mediastinal mass or widening of the mediastinum on imaging studies. Mediastinal widening is diagnosed by the mediastinum measuring greater than 8 cm in width on PA chest x-ray. The mediastinal mass may present with symptoms caused by the mass pressing against other organs or even without any symptoms. Mediastinal masses can be differentiated on the basis of location in the mediastinal cavity into 3 groups: Prevascular, visceral and paravertebral.
 
==Mediastinal Anatomy==
 
===Causes in Alphabetical Order<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref><ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>===


*[[Anthrax]]: This is a classic finding associated with inhaled [[anthrax]]. A widened mediastinum was found in 7 of the first 10 victims infected ''Bacillus anthracis'' in 2001.<ref name="pmid11747719">{{cite journal |author=Jernigan JA, Stephens DS, Ashford DA, ''et al'' |title=Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States |journal=Emerging Infect. Dis. |volume=7 |issue=6 |pages=933–44 |year=2001 |pmid=11747719 |doi=}}</ref>
{| class="wikitable"
*[[Aortic dissection]]
|+
*[[Bronchogenic cyst]]
!Compartments
*[[Churg-Strauss syndrome]]
!Boundaries
*[[Dermoid cyst]]
!Components
*[[Esophageal achalasia]]
|-
*[[Esophageal cancer]]
|Prevascular
*[[Esophageal rupture]]
|
*[[Goitre]]
* Superior: Thoracic inlet
*[[Hiatus hernia]]
* Inferior: Diaphragm
*[[Hilar lymphadenopathy]]
* Anterior: Sternum
*[[Lymphoma]]
* Posterior: Anterior aspect of pericardium
*[[Mediastinal germ cell tumor]]
* Lateral: Parietal mediastinal pleura
*[[Mediastinal tumor]]
|
*[[Mediastinitis]]
* Thymus
*[[Neurilemmoma]]
* Fat
*[[Non-Hodgkin lymphoma]]
* Lymph nodes
*[[Partial anomalous pulmonary venous connection]]
* Left brachiocephalic vein
*[[Pericardial effusion]]
|-
*[[Pneumomediastinum]]
|Visceral
*[[Sarcoidosis]]
|
*[[Superior vena cava obstruction]]
* Superior: Thoracic inlet
*Supine AP [[chest x ray]] can yield a false positive "widened mediastinum": Among patients who have sustained blunt traum, AP chest radiographs are often obtained in the supine position to maintain spinal precautions. This supine position may result in fluid shifts that are in turn associated with a widening of the mediastinum. After the spine had been "cleared", some authors recommend repeating the chest X ray with the patient in the erect position which results in normalization of the mediastinal size in around 40% of patients.
* Inferior: Diaphragm
*[[Teratoma]]
* Anterior: Posterior boundaries of prevascular compartment
*[[Thymoma]]
* Posterior: Vertical line connecting a point on each thoracic vertebral body 1 cm posterior to its origin
*[[Thyroid cancer]]
|
*[[Tuberculosis]]
*
|-
|Paravertebral
|
* Superior: Thoracic inlet
* Inferior: Diaphragm
* Anterior: Posterior bounderies of visceral compartment
* Posterolateral: Vertical line agaiinst the posterior margin of the chest wall at the lateral margin of the transvers process of tthoracicspine
* Lateral
|
*
|}


==References==
==References==

Revision as of 21:35, 18 February 2019

Mediastinal mass Microchapters

Home

Overview

Anatomy of Mediastinum

Causes

Differentiating Mediastinal Mass from other Diseases

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2], Amr Marawan, M.D. [3]

Synonyms and keywords: Mediastinal enlargement; mass in the mediastinum

Overview

The mediastinum is a non-delineated group of structures in the thorax (chest), surrounded by loose connective tissue. It is the central compartment of the thoracic cavity. It contains the heart, the great vessels of the heart, esophagus, trachea, thymus, and lymph nodes of the central chest. A wide variety of diseases involving these organs can present as a mediastinal mass or widening of the mediastinum on imaging studies. Mediastinal widening is diagnosed by the mediastinum measuring greater than 8 cm in width on PA chest x-ray. The mediastinal mass may present with symptoms caused by the mass pressing against other organs or even without any symptoms. Mediastinal masses can be differentiated on the basis of location in the mediastinal cavity into 3 groups: Prevascular, visceral and paravertebral.

Compartments Boundaries Components
Prevascular
  • Superior: Thoracic inlet
  • Inferior: Diaphragm
  • Anterior: Sternum
  • Posterior: Anterior aspect of pericardium
  • Lateral: Parietal mediastinal pleura
  • Thymus
  • Fat
  • Lymph nodes
  • Left brachiocephalic vein
Visceral
  • Superior: Thoracic inlet
  • Inferior: Diaphragm
  • Anterior: Posterior boundaries of prevascular compartment
  • Posterior: Vertical line connecting a point on each thoracic vertebral body 1 cm posterior to its origin
Paravertebral
  • Superior: Thoracic inlet
  • Inferior: Diaphragm
  • Anterior: Posterior bounderies of visceral compartment
  • Posterolateral: Vertical line agaiinst the posterior margin of the chest wall at the lateral margin of the transvers process of tthoracicspine
  • Lateral

References

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