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==Overview==
==Overview==
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]].
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 [[Disease|diseases]] involving these organs can present as a mediastinal mass or widening of the [[mediastinum]] on [[imaging studies]].


==Causes==
==Causes==

Revision as of 16:42, 19 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]

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.

Causes

Following can appear as a mediastinal mass on imaging studies:

Disease
Cardiovascular causes
Gastrointestinal causes
Pulmonary causes
CNS diseases
Thyroid diseases
Mediastinal tumors
Cystic mass
Other

Causes by Organ System

Cardiovascular
Chemical / poisoning No underlying causes
Dermatologic Dermoid cyst
Drug Side Effect No underlying causes
Ear Nose Throat
Endocrine
  • Goitre, when more than 50% of the mass is located below the thoracic inlet, is termed intrathoracic goitre[46] which appear as mediastinal mass.
  • Thyroid cancer
Environmental Intrathoracic goitre
Gastroenterologic
Genetic No underlying causes
Hematologic
Iatrogenic Mediastinitis
Infectious Disease
Musculoskeletal / Ortho No underlying causes
Neurologic Mediastinal neurilemmoma may originate from right phrenic nerve[54], intrathoracic vagal nerve[55]
Nutritional / Metabolic Intrathoracic goitre
Obstetric/Gynecologic No underlying causes
Oncologic
Opthalmologic No underlying causes
Overdose / Toxicity Inhaled recreational drugs such as cocaine which induced bronschospasm, increased alveolar pressure followed by alveolar rupture leading to interstitial emphysema and pneumomediastinum[56].
Psychiatric No underlying causes
Pulmonary
Renal / Electrolyte No underlying causes
Rheum / Immune / Allergy
Sexual No underlying causes
Trauma
Urologic No underlying causes
Miscellaneous
  • Dermoid cyst is thick-walled and contains various tissue materials of skin, hair, occasionally teeth, and caseous (cheesy) substance. They are usually found in the front of the chest, but rarely are located within the pericardium. If not removed, it may get infected and rupture.
  • Supine AP chest x ray can yield a false positive "widened mediastinum".

Causes in Alphabetical Order

References

  1. ↑ Cohen R, Mena D, Carbajal-Mendoza R, Matos N, Karki N (2008). "Superior vena cava syndrome: A medical emergency?". Int. J. Angiol. 17 (1): 43–6. PMID 22477372.
  2. ↑ Sears EH, Aliotta JM, Klinger JR (2012). "Partial anomalous pulmonary venous return presenting with adult-onset pulmonary hypertension". Pulm Circ. 2 (2): 250–5. doi:10.4103/2045-8932.97637. PMC 3401879. PMID 22837866.
  3. ↑ Broy C, Bennett S (June 2008). "Partial anomalous pulmonary venous return". Mil Med. 173 (6): 523–4. PMID 18595412.
  4. ↑ 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.
  5. ↑ Salem K, Mulji A, Lonn E (November 1999). "Echocardiographically guided pericardiocentesis - the gold standard for the management of pericardial effusion and cardiac tamponade". Can J Cardiol. 15 (11): 1251–5. PMID 10579740.
  6. ↑ Brooke V, Goswami S, Mohanty A, Kasi PM (2012). "Aortic dissection and renal failure in a patient with severe hypothyroidism". Case Rep Med. 2012: 842562. doi:10.1155/2012/842562. PMC 3399550. PMID 22829842.
  7. ↑ "Classification of diabetic retinopathy from fluorescein angiograms. ETDRS report number 11. Early Treatment Diabetic Retinopathy Study Research Group". Ophthalmology. 98 (5 Suppl): 807–22. 1991. PMID 2062514.
  8. ↑ Gockel I, Müller M, Schumacher J (2012). "Achalasia--a disease of unknown cause that is often diagnosed too late". Dtsch Arztebl Int. 109 (12): 209–14. doi:10.3238/arztebl.2012.0209. PMC 3329145. PMID 22532812.
  9. ↑ Ghoshal UC, Daschakraborty SB, Singh R (2012). "Pathogenesis of achalasia cardia". World J. Gastroenterol. 18 (24): 3050–7. doi:10.3748/wjg.v18.i24.3050. PMC 3386318. PMID 22791940.
  10. ↑ Nakajima S, Hattori T. Oesophageal adenocarcinoma or gastric cancer with or without eradication of Helicobacter pylori infection in chronic atrophic gastritis patients: a hypothetical opinion from a systematic review. Aliment Pharmacol Ther. 2004 Jul;20 Suppl 1:54-61. PMID 15298606
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  14. ↑
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  16. ↑ Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A (2014). "Peripheral lymphadenopathy: approach and diagnostic tools". Iran J Med Sci. 39 (2 Suppl): 158–70. PMC 3993046. PMID 24753638.
  17. ↑ Lymph node enlargment. Radiopedia. http://radiopaedia.org/articles/lymph-node-enlargement Accessed on May 9, 2016
  18. ↑ Chiu CY, Wong KS, Yao TC, Huang JL (March 2005). "Asthmatic versus non-asthmatic spontaneous pneumomediastinum in children". Asian Pac. J. Allergy Immunol. 23 (1): 19–22. PMID 15997870.
  19. ↑ Iyer VN, Joshi AY, Ryu JH (May 2009). "Spontaneous pneumomediastinum: analysis of 62 consecutive adult patients". Mayo Clin. Proc. 84 (5): 417–21. doi:10.1016/S0025-6196(11)60560-0. PMC 2676124. PMID 19411438.
  20. ↑ Dionísio, Patrícia; Martins, Luís; Moreira, Susana; Manique, Alda; Macedo, Rita; Caeiro, Fátima; Boal, Luísa; Bárbara, Cristina (2017). "Spontaneous pneumomediastinum: experience in 18 patients during the last 12 years". Jornal Brasileiro de Pneumologia. 43 (2): 101–105. doi:10.1590/s1806-37562016000000052. ISSN 1806-3756.
  21. ↑ Teirstein AS, Judson MA, Baughman RP, et al: The spectrum of biopsy sites for the diagnosis of sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 22(2):139 146, 2005.
  22. ↑ Judson MA, Boan AD, Lackland DT: The clinical course of sarcoidosis: presentation, diagnosis, and treatment in a large white and black cohort in the United States. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG 2012, 29(2):119-127.
  23. ↑ "Symptoms | Anthrax | CDC".
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  27. ↑ 27.00 27.01 27.02 27.03 27.04 27.05 27.06 27.07 27.08 27.09 27.10 27.11 27.12 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.
  28. ↑ "What is Spina Bifida | CDC".
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  30. ↑ "Schwannoma | Genetic and Rare Diseases Information Center (GARD) – an NCATS Program".
  31. ↑ "Benign thyroid enlargement (non-toxic multinodular goiter): Overview".
  32. ↑ 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.
  33. ↑ 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.
  34. ↑ J. J. Goedert, T. R. Cote, P. Virgo, S. M. Scoppa, D. W. Kingma, M. H. Gail, E. S. Jaffe & R. J. Biggar (1998). "Spectrum of AIDS-associated malignant disorders". Lancet (London, England). 351 (9119): 1833–1839. PMID 9652666. Unknown parameter |month= ignored (help)
  35. ↑ M. Tinguely, R. Vonlanthen, E. Muller, C. C. Dommann-Scherrer, J. Schneider, J. A. Laissue & B. Borisch (1998). "Hodgkin's disease-like lymphoproliferative disorders in patients with different underlying immunodeficiency states". Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc. 11 (4): 307–312. PMID 9578079. Unknown parameter |month= ignored (help)
  36. ↑ 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.
  37. ↑ 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.
  38. ↑ Carr RF, Ochs RH, Ritter DA, Kenny JD, Fridey JL, Ming PM (June 1986). "Fetal cystic hygroma and Turner's syndrome". Am. J. Dis. Child. 140 (6): 580–3. PMID 3706240.
  39. ↑ Setty, HAN; Hegde, KKS; Narvekar, VN (2005). "Neurenteric cyst of the posterior mediastinum". Australasian Radiology. 49 (2): 151–153. doi:10.1111/j.1440-1673.2005.01360.x. ISSN 0004-8461.
  40. ↑ Elta, Grace H; Enestvedt, Brintha K; Sauer, Bryan G; Marie Lennon, Anne (2018). "ACG Clinical Guideline: Diagnosis and Management of Pancreatic Cysts". The American Journal of Gastroenterology. 113 (4): 464–479. doi:10.1038/ajg.2018.14. ISSN 0002-9270.
  41. ↑ Kondov, Goran; Kondov, Borislav; Srceva, Marija Jovanovska; Damjanovski, Goge; Ferati, Imran; Karapetrov, Ivan; Topuzovska, Irena Kondova; Tanevska, Nikolina; Kokareva, Anita (2017). "Giant Mediastinal Thymic Cyst". PRILOZI. 38 (2): 139–145. doi:10.1515/prilozi-2017-0032. ISSN 1857-8985.
  42. ↑ Symptoms of mediastinitis. Right Diagnosis (2015). http://www.rightdiagnosis.com/m/mediastinitis/symptoms.htm Accessed on September 28, 2015
  43. ↑ Mediastinitis: parotid abscess complication. Brazilian Journal of Otorhinolaryngology (2013). http://www.scielo.br/scielo.php?pid=S1808-86942014000300268&script=sci_arttext Accessed on September 28, 2015
  44. ↑ Silva CI, Müller NL, Fujimoto K, Johkoh T, Ajzen SA, Churg A (May 2005). "Churg-Strauss syndrome: high resolution CT and pathologic findings". J Thorac Imaging. 20 (2): 74–80. PMID 15818205.
  45. ↑ Feng RE, Xu WB, Shi JH, Mahmoudi A, Mu WB, Zheng WJ, Zhu YJ, Liu HR (March 2011). "Pathological and high resolution CT findings in Churg-Strauss syndrome". Chin. Med. Sci. J. 26 (1): 1–8. PMID 21496416.
  46. ↑ Netterville JL, Coleman SC, Smith JC, Smith MM, Day TA, Burkey BB (1998). "Management of substernal goiter". Laryngoscope. 108 (11 Pt 1): 1611–7. PMID 9818814.
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  48. ↑ Corsten MJ, Shamji FM, Odell PF, Frederico JA, Laframboise GG, Reid KR, et al. Optimal treatment of descending necrotising mediastinitis. Thorax 1997;52:702-8.
  49. ↑ Wheatley MJ, Stirling MC, Kirsch MM, Gago O, Orringer MB. Descending necrotizing mediastinitis: transcervical drainage is not enough. Ann Thorac Surg 1990;49:780-4.
  50. ↑ Estrera AS, Landay MJ, Grisham JM, Sinn DP, Platt MR. Descending necrotizing mediastinitis. Surg Gynecol Obstet 1983;157:545-52.
  51. ↑ Alsoub H, Chacko KC. Descending necrotising mediastinitis. Postgrad Med J 1995;71:98-101.
  52. ↑ Sakamoto H, Aoki T, Kise Y, Watanabe D, Sasaki J (2000). "Descending necrotizing mediastinitis due to odontogenic infections". Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 89 (4): 412–9. PMID 10760723.
  53. ↑ Jernigan JA, Stephens DS, Ashford DA; et al. (2001). "Bioterrorism-related inhalational anthrax: the first 10 cases reported in the United States". Emerging Infect. Dis. 7 (6): 933–44. PMID 11747719.
  54. ↑ Hirose H, Ohmori K, Nakaoka Y, Kitamura K, Muramatsu T, Namiki Y; et al. (1998). "[Mediastinal neurilemmoma originating in the right phrenic nerve: a case report]". Nihon Kokyuki Gakkai Zasshi. 36 (12): 1027–31. PMID 10064956.
  55. ↑ Ito I, Komota K, Nakajima T, Ishibashi K, Kawazoe K (1994). "[A case of mediastinal neurilemmoma originating from the intrathoracic vagal nerve]". Kyobu Geka. 47 (4): 325–7. PMID 8152184.
  56. ↑ Panacek EA, Singer AJ, Sherman BW, Prescott A, Rutherford WF (1992). "Spontaneous pneumomediastinum: clinical and natural history". Ann Emerg Med. 21 (10): 1222–7. PMID 1416301.
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