Mediastinal mass: Difference between revisions
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The [[mediastinum]] is a non-delineated group of structures in the [[Thorax|thorax (chest)]], surrounded by [[loose connective tissue]]. It is the central [[Compartment (anatomy)|compartment]] of the [[thoracic cavity]]. It contains the [[heart]], the [[great vessels]] of the [[heart]], [[esophagus]], [[trachea]], [[thymus]], and [[Lymph node|lymph nodes]] of the [[Mediastinum|central chest]]. A wide variety of [[Mediastinal mass causes|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 [[Chest x-ray|PA chest x-ray]]. The mediastinal mass may present with [[Symptom|symptoms]] caused by the [[Tumor|mass]] pressing against other [[Mediastinum|mediastinal structures]] or even without any [[Symptom|symptoms]]. Mediastinal masses can be differentiated on the basis of location in the [[Mediastinum|mediastinal cavity]] into 3 groups: [[Anterior mediastinum|Prevascular]], [[Middle mediastinum|visceral]] and [[Posterior mediastinum|paravertebral]]. | The [[mediastinum]] is a non-delineated group of structures in the [[Thorax|thorax (chest)]], surrounded by [[loose connective tissue]]. It is the central [[Compartment (anatomy)|compartment]] of the [[thoracic cavity]]. It contains the [[heart]], the [[great vessels]] of the [[heart]], [[esophagus]], [[trachea]], [[thymus]], and [[Lymph node|lymph nodes]] of the [[Mediastinum|central chest]]. A wide variety of [[Mediastinal mass causes|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 [[Chest x-ray|PA chest x-ray]]. The mediastinal mass may present with [[Symptom|symptoms]] caused by the [[Tumor|mass]] pressing against other [[Mediastinum|mediastinal structures]] or even without any [[Symptom|symptoms]]. Mediastinal masses can be differentiated on the basis of location in the [[Mediastinum|mediastinal cavity]] into 3 groups: [[Anterior mediastinum|Prevascular]], [[Middle mediastinum|visceral]] and [[Posterior mediastinum|paravertebral]]. | ||
== | ==Anatomy of mediastinum== | ||
[[Anatomy|Anatomically]], [[Mediastinum|mediastinal cavity]] is divided into following [[compartments]]:<ref name="CarterBenveniste2017">{{cite journal|last1=Carter|first1=Brett W.|last2=Benveniste|first2=Marcelo F.|last3=Madan|first3=Rachna|last4=Godoy|first4=Myrna C.|last5=de Groot|first5=Patricia M.|last6=Truong|first6=Mylene T.|last7=Rosado-de-Christenson|first7=Melissa L.|last8=Marom|first8=Edith M.|title=ITMIG Classification of Mediastinal Compartments and Multidisciplinary Approach to Mediastinal Masses|journal=RadioGraphics|volume=37|issue=2|year=2017|pages=413–436|issn=0271-5333|doi=10.1148/rg.2017160095}}</ref> | |||
* Prevascular (anterior) | * [[Anterior mediastinum|Prevascular (anterior)]] | ||
* Visceral (middle) | * [[Middle mediastinum|Visceral (middle)]] | ||
* Paravertebral (posterior) | * [[Posterior mediastinum|Paravertebral (posterior)]] | ||
{| | {| | ||
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Intenational Thymic Malignancy Interest Group (ITMIG) Classification of Mediastinum''' | ! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Intenational Thymic Malignancy Interest Group (ITMIG) Classification of Mediastinum''' | ||
| Line 26: | Line 26: | ||
* '''Inferior:''' [[Thoracic diaphragm|Diaphragm]] | * '''Inferior:''' [[Thoracic diaphragm|Diaphragm]] | ||
* '''Anterior:''' [[Sternum]] | * '''Anterior:''' [[Sternum]] | ||
* '''Posterior:''' Anterior aspect of the [[pericardium]] | * '''Posterior:''' [[Anatomical terms of location|Anterior]] aspect of the [[pericardium]] | ||
* '''Lateral:''' [[Parietal pleura|Parietal mediastinal pleura]] | * '''Lateral:''' [[Parietal pleura|Parietal mediastinal pleura]] | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| Line 38: | Line 38: | ||
* '''Superior:''' [[Superior thoracic aperture|Thoracic inlet]] | * '''Superior:''' [[Superior thoracic aperture|Thoracic inlet]] | ||
* '''Inferior:''' [[Thoracic diaphragm|Diaphragm]] | * '''Inferior:''' [[Thoracic diaphragm|Diaphragm]] | ||
* '''Anterior:''' Posterior boundaries of the prevascular compartment | * '''Anterior:''' [[Anatomical terms of location|Posterior]] boundaries of the [[Anterior mediastinum|prevascular compartment]] | ||
* '''Posterior:''' [[Vertical direction|Vertical]] line connecting a point on each [[Thoracic vertebrae|thoracic]] [[Body of vertebra|vertebral body]] 1 cm posterior to its origin | * '''Posterior:''' [[Vertical direction|Vertical]] line connecting a point on each [[Thoracic vertebrae|thoracic]] [[Body of vertebra|vertebral body]] 1 cm [[Anatomical terms of location|posterior]] to its origin | ||
| style="background: #F5F5F5; padding: 5px;" |'''Non vascular:''' | | style="background: #F5F5F5; padding: 5px;" |'''Non vascular:''' | ||
* [[Trachea]] | * [[Trachea]] | ||
| Line 60: | Line 60: | ||
* '''Superior:''' [[Superior thoracic aperture|Thoracic inlet]] | * '''Superior:''' [[Superior thoracic aperture|Thoracic inlet]] | ||
* '''Inferior:''' [[Thoracic diaphragm|Diaphragm]] | * '''Inferior:''' [[Thoracic diaphragm|Diaphragm]] | ||
* '''Anterior:''' Posterior boundaries of the visceral compartment | * '''Anterior:''' [[Anatomical terms of location|Posterior]] boundaries of the [[Middle mediastinum|visceral compartment]] | ||
* '''Posterolateral:''' Vertical line against the posterior margin of the [[Thoracic cavity|chest wall]] at the lateral margin of the [[Transverse processes|transverse process]] of the [[Thoracic vertebrae|thoracic spine]] | * '''Posterolateral:''' Vertical line against the [[Anatomical terms of location|posterior]] margin of the [[Thoracic cavity|chest wall]] at the [[lateral]] margin of the [[Transverse processes|transverse process]] of the [[Thoracic vertebrae|thoracic spine]] | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* [[Thoracic vertebrae|Thoracic spine]] | * [[Thoracic vertebrae|Thoracic spine]] | ||
Revision as of 15:09, 19 February 2019
|
Mediastinal mass Microchapters |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]
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 mediastinal structures 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.
Anatomy of mediastinum
Anatomically, mediastinal cavity is divided into following compartments:[1]
| Intenational Thymic Malignancy Interest Group (ITMIG) Classification of Mediastinum | ||
|---|---|---|
| Compartments | Boundaries | Components |
| Prevascular |
|
|
| Visceral |
|
Non vascular:
Vascular:
|
| Paravertebral |
|
|
| Adapted from Radiographics | ||
References
- ↑ Carter, Brett W.; Benveniste, Marcelo F.; Madan, Rachna; Godoy, Myrna C.; de Groot, Patricia M.; Truong, Mylene T.; Rosado-de-Christenson, Melissa L.; Marom, Edith M. (2017). "ITMIG Classification of Mediastinal Compartments and Multidisciplinary Approach to Mediastinal Masses". RadioGraphics. 37 (2): 413–436. doi:10.1148/rg.2017160095. ISSN 0271-5333.