Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pulmonary > Mediastinal Diseases > Flashcards

Mediastinal Diseases Flashcards

1
Q

diagnostic problems for mediastinal pathology

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most common type of mediastinal tumors?

A

neurogenic tumors

thymoma

cysts

lymphoma

germ cell tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

structures found in the mediastinum

A

thumas

parathyroids

heart

lungs

trachea

esophagus

great vessels

lymph nodes

intercostal nerves and sympathetic ganglia

supporting mesenchymal and bony structures and mesothelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where are malignant mediastinal tumors mainly found?

A

anterior/superior compartment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Major tumors of the superior mediastinum

A

four T’s:

thymoma

T-cell-rich lymphomas

teratomas (and other germ cell tumors)

thyroid (and parathyroid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

major pathological process of the middle mediastinum

A

bronchogenic/pericardial cyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

major pathological processes of the posterior mediastinum

A

neurilemmoma

neurofibroma

ganglioneuroma/neuroblastoma

malignant PNST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

major pathological processes of the anterior mediastinum

A

thymoma

germ cell tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

malignant vs. benign tumors of the mediastinum

A

80% of asymptomatic processes are benign

25% of 40% of mediastinal tumors are malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

diagnostic techniques for mediastinal masses.

A

CR and MRI

ultrasound

nuclear scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

methods for mediastinum biopsy

A

CT-guided needle biopsy

cervical mediastinoscopy and parasternal mediastinotomy

VATS - video-assisted thoracoscopy

open thoracotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the types of thymus hyperplasia?

A

true hyperplasia

follicular thymic hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

true hyperplasia

A

increase in all elements of th ethymus, so weight is greater than expected for age

compensatory hyperplasia observed after stressful events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

follicular thymic hyperplasia

A

increase in B and T cells lymphodi follicles

observed in close to 75% o fpatients with myasthenia gravis and other autoimmune diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

thymoma

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

histological classification of thymomas

A

generally benign

classified as spindled or epithelioid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Type A thymoma

A

spindle cell, good prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Type B thymoma

A

B1 - lymphocyte-rich, scattered epithelial cells

B2 - lymphocytes = epithelial cells

B3 - epithelial-rich, scattered lymphocytes

B3>B2>B1 in terms of prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Type C thymoma

A

thymic carcinoma

poor prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Masaoka stage 1

A

completely encapsulated thymoma macroscopically and microscopically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Masaoka stage 2

A

thymoma macroscopically invades fatty tissue outside thymus, or microscopically invades through capsule

22
Q

Masaoka stage 3

A

tumor macroscopically invades into neighboring organs such as great vessels, lung, or pericardium

23
Q

Masaoka stage 4

A

lymphatic or hematogenous metastasis, or disseminated pleural/ericardial spread

24
Q

treatment for thymomas

A

thoracotomy and complete excision

complete excision and radiotherapy with/without chemotherapy

25
Q

primary lymphoma of mediastinum and types of disease found here

A

commonly located anteriosuperior, and less often, middle mediastinum

Hodgkin’s Lymphoma/Disease - most common

acute lymphoblastic leukemia/lymphoma (NHL) - most common in non-Hodgkin’s lymphoma in children/adolescents

mediastinal large cell lymphoma (B-cell type) - most common primary form of NHL in adults

26
Q

Hodgkin’s Lymphoma

A

most common, presents in young adult females as an anterosuperior mediastinal mass

treated with chemotherapy and radiation

Reed-Sternberg cells are diagnostic in the histology

27
Q

acute lymphoblastic leukemia/lymphoma

A

T-cell type

a rapidly progresssive lymphoma that quickly involves blood, and lymph nodes, and bone

found in children/adolescent males

SVC syndrome, respiratory distress

treat with intense chemotherapy and bone marrow transplant

28
Q

mediastinal large cell lymphoma

A

B-cell type

found in young females

usually tumor confined to chest

majority go into complete remission with intensive chemotherapy wiht/without radiation

29
Q

germ cell tumors

A

found in anterior mediastinum

subtypes include:

teratoma - most common

germinoma (seminoma)

other GCTs more commonly associatd with Klinefelter syndrome

30
Q

teratoma

A

most common in adolescents

neonates and young children have good prognosis

in postpubertal patients prognosis is worse if associated with other malignant germ cells, immature elements, or somatic malignancy

31
Q

histologic findings of teratoma

A

mucosa and skin adnexa with underlying mucinous glands

32
Q

seminoma

A

most common malignant germ cell tumor

almost exclusively in males

most patients symptomatic, 10% have SVC

good prognosis if treated with chemotherapy or radiation

33
Q

histology of seminomas

A

epithelioid cells with cleared (glycogenated) cytoplasm and large nuclei with nucleoli arranged in nests surrounded by fibrovascular stroma with lymphocytes

34
Q

beta-HCG

A

high levels strongly suggest the presence of highyl aggressive choriocarcinoma

35
Q

What is the marker for yold sac tumors?

A

high levels of serum alpha-fetoprotein

36
Q

neuroendocrine tumors o fthe mediastinum

A

carcinoid tumors

located in the anteriosuperior mediastinum

35% functional, ACTH most comon hormone produced

prognosis is poor, particularly in patients with tumors exhibiting metastatic spread

37
Q

histology of carcinoid tumors

A

epithelial cells with rounded nuclei having finely granular (salt and pepper) chromatin

rosette formation is common

38
Q

neurogenic tumors

A

located in the posterior mediastinum

scwannoma is most common

neurofibroma is next - associated with neurofibromatosis type I

39
Q

histology of as schwannoma

A

encapsulated, admixture of cellular Antoni A areas with Verocay bodies and hypocellular vascular antoni B areas

dumbbell shaped tumor that can occasionally extend inside the spinal canal

treated with complete resection

40
Q

neurofibroma

A

condition associated with malignant peripheral nerve sheath tumors

plexiform neurofibroma and malignant schwannoma

41
Q

histology of plexiform neurofibromas

A

distended and enlarged nerve fascicles composed of Schwann cells, fibroblasts, and neurites in a myxoid stroma

42
Q

histology of malignant schwannoma

A

cellular fascicles of highly atypical spindled cells with irregular nuclear contours

stroma may be focally myxoid

43
Q

ganglioneuroma

A

older children and adults

usually asymptomatic, but may be associated with diarrhea

diarrhea due to vasoactive intestinal polypeptide production by ganglion cells

44
Q

histology of ganglioneuromas

A

fascicles of elongated Schwann cels and mature (but dysplastic) ganglion cells

45
Q

cysts of the mediastinum

A

thymic cyst

pericardial cyst

bronchogenic cyst

surgery is treatment of choice

46
Q

thymic cyst

A

located in th eanterosuperior mediastinum

generally asymptomatic in adults

unilocular if congenital

multilocular if acquired

47
Q

histology of thymic cysts

A

inflammation, residual thymic tissue in 50% of cases, degenerative features influding presence of cholesterol clefts

48
Q

lesions of the mediastinum

A

chronic fibrosing mediastinitis

infectious granulomas

sarcoidosis

49
Q

chronic fibrosing mediastinitis

A

located in the middle/anterior mediastinum

present with chest pain, fever, hemoptysis, SVC syndrome

two important forms are infectious lymphadenitis (due to histoplasma) and IgG type 4 plasma-cell diseases (responds to steroids)

can also be caused by other types of granulomatous disease, including TB

50
Q

histology of fibrosing mediastinitis

A

lymphoplasmacytic inflammation and fibroblasts and dense fibrosis are histologic features associated with IgG type 4 lesions

obliterative phlebitis is a common finding

Pulmonary (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions