General Medicine

Question 1

What are the components of the anterior mediastinum?

Answer 1

Posterior surface of sternum to anterior aspect of great vessels and pericardium

Contains 3 major structures: Thymus, Lymph nodes, Fat

Question 2

What are the components of the middle mediastinum?

Answer 2

Anterior pericardium to ventral surface of the thoracic spine

Contains 5 major structures: 
Heart and pericardium
Great vessels (SVC, PA, ascending aorta)
Airway and bronchus
Esophagus
Lymph nodes

Question 3

What are the components of the posterior mediastinum?

Answer 3

Spine and costovertebral sulci

Contains 3 major structures:
Neurovascular bundles
Spinal ganglia
Sympathetic chain

Question 4

What are the 4 T’s of anterior mediastinal masses?

Answer 4

Thymoma
Teratoma/Germ cell tumors
Thyroid (intrathoracic tissue)
“Terrible” lymphoma

Question 5

What is the differential for middle mediastinal masses?

Answer 5

Lymphadenopathy; Lymphoma, Sarcoid, and Metastatic lung cancer
Benign cystic masses; Bronchogenic cyst and Pericardial cyst
Advanced esophageal tumor

Question 6

What is the differential for posterior mediastinal masses?

Answer 6

Predominantly neurogenic tumors such as:
Schwannomas and neurofibromas are benign lesions from the intercostal nerve sheath
Neuroblastoma and Ganglioneuroblastoma are malignant
Ganglioneuromas are benign lesions from the sympathetic ganglion
Paraganglionic cells give rise to pheochromocytomas