Mediastinal Diseases Flashcards
diagnostic problems for mediastinal pathology
the mediastinum is a confined space that is difficult to clinically evaluate and adequately biopsy
there are many organs in this small compartment that can have many different pathologic processes
What is the most common type of mediastinal tumors?
neurogenic tumors
thymoma
cysts
lymphoma
germ cell tumors
structures found in the mediastinum
thumas
parathyroids
heart
lungs
trachea
esophagus
great vessels
lymph nodes
intercostal nerves and sympathetic ganglia
supporting mesenchymal and bony structures and mesothelium
Where are malignant mediastinal tumors mainly found?
anterior/superior compartment
Major tumors of the superior mediastinum
four T’s:
thymoma
T-cell-rich lymphomas
teratomas (and other germ cell tumors)
thyroid (and parathyroid)
major pathological process of the middle mediastinum
bronchogenic/pericardial cyst
major pathological processes of the posterior mediastinum
neurilemmoma
neurofibroma
ganglioneuroma/neuroblastoma
malignant PNST
major pathological processes of the anterior mediastinum
thymoma
germ cell tumors
malignant vs. benign tumors of the mediastinum
80% of asymptomatic processes are benign
25% of 40% of mediastinal tumors are malignant
diagnostic techniques for mediastinal masses.
CR and MRI
ultrasound
nuclear scan
methods for mediastinum biopsy
CT-guided needle biopsy
cervical mediastinoscopy and parasternal mediastinotomy
VATS - video-assisted thoracoscopy
open thoracotomy
What are the types of thymus hyperplasia?
true hyperplasia
follicular thymic hyperplasia
true hyperplasia
increase in all elements of th ethymus, so weight is greater than expected for age
compensatory hyperplasia observed after stressful events
follicular thymic hyperplasia
increase in B and T cells lymphodi follicles
observed in close to 75% o fpatients with myasthenia gravis and other autoimmune diseases
thymoma
most common tumor of the anterior and superior mediastinum
mostly asymptomatic, 1/3 have chest pain, cough, dyspnea, or superior vena cava syndrome
30-50% are associated with myasthenia gravis
histological classification of thymomas
generally benign
classified as spindled or epithelioid
Type A thymoma
spindle cell, good prognosis
![](https://s3.amazonaws.com/brainscape-prod/system/cm/083/350/074/a_image_thumb.png?1659420037)
Type B thymoma
B1 - lymphocyte-rich, scattered epithelial cells
B2 - lymphocytes = epithelial cells
B3 - epithelial-rich, scattered lymphocytes
B3>B2>B1 in terms of prognosis
![](https://s3.amazonaws.com/brainscape-prod/system/cm/083/350/199/a_image_thumb.png?1659420037)
Type C thymoma
thymic carcinoma
poor prognosis
![](https://s3.amazonaws.com/brainscape-prod/system/cm/083/350/360/a_image_thumb.png?1659420038)
Masaoka stage 1
completely encapsulated thymoma macroscopically and microscopically