Sandbox:Trusha

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

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  1. Superior vena cava obstruction
  2. Partial anomalous pulmonary venous connection
  3. Esophageal achalasia
  4. Esophageal cancer
  5. Esophageal rupture
  6. Hiatus hernia
  7. Hilar lymphadenopathy
  8. Pneumomediastinum
  9. Sarcoidosis
  10. Lymphoma
  11. Neurilemmoma
  12. Non-Hodgkin lymphoma
  13. Teratoma
  14. 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
CT scan showing A large soft tissue attenuation mass occupying the anterior mediastinal displaying homogenous attenuation with low-density areas of cystic changes inside. It extends to the middle mediastinum to occupy the pretracheal space and involve the right hilum. Inferiorly it is inseparable from the anterior pericardium. Compression upon the SVC and encasement of the aorta and great vessels are noted. There is also mild right costal pleural thickening and enhancement suggesting infiltration with mild pleural effusion and abdominal retrocaval lymph nodes. Case courtesy of Dr Ahmed Abdrabou (Picture courtesy: Radiopedia)


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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])



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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4]; Associate Editor(s)-in-Chief: Trusha Tank, M.D.[5], Amr Marawan, M.D. [6]

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. 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.

Causes

Causes in Alphabetical Order[1][2]

Initial Evaluation

 
 
 
 
Mediastinal Mass
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Workups

❑ CT chest with contrast
❑ Serum beta-HCG, AFP, if appropriate
❑ CBC, platelets
❑ PET-CT scan (optional)
❑ Pulmonary function tests if clinically indicated
❑ MRI chest if clinically indicated

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Thymic Tumor Likely
 
 
 
 
 
Thymic Tumor Unlikely
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Consider surgery
 
 
 
 
 
Disease-specific management
 
 
 

References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
  3. 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.