Mediastinal Masses Flashcards

1
Q

What are the boundaries of the mediastinum?

A

Thoracic inlet superiorly, diaphragm inferiorly, pleural space to pleural space laterally, and sternum anteriorly to thoracic spine posteriorly

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2
Q

What are the three compartments of the mediastinum?

A

Anterosuperior, middle, and posterior

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3
Q

What is the border between the anterosuperior and middle mediastinum

A

Anterior pericardium

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4
Q

What is the border between the middle and posterior mediastinum?

A

Anterior border of vertebral bodies

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5
Q

What lab tests should be sent in patients with anterior mediastinal masses?

A

AFP, beta-HCG, LDH

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6
Q

What tumors are associated with increased levels of AFP and beta-HCG?

A

Non-seminomatous malignant germ cell tumors

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7
Q

What is the most common isolated anterior mediastinal tumor?

A

Thymoma

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8
Q

T/F: FNA or core needle bx of thymomas are often non-diagnostic?

A

TRUE

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9
Q

What approach should be used to resect a thymoma?

A

Median sternotomy

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10
Q

How should locally advanced (stage III) thymomas be treated?

A

Chemo, followed by surgery and adjuvant radiation

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11
Q

What paraneoplastic syndrome is associated with thymomas?

A

Myasthenia gravis

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12
Q

What are the two classifications of germ cell tumors?

A

Seminomas and non-seminomatous germ cell tumors

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13
Q

What is the definition of a teratoma?

A

Disorganized elements from all three germinal layers (ectoderm, mesoderm, endoderm)

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14
Q

Which germ cell tumor has surgery as its primary treatment?

A

Benign mediastinal teratomas

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15
Q

What is the primary treatment for seminomas?

A

XRT

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16
Q

T/F: FNA samples are sufficient for diagnosis of lymphoma.

A

FALSE

17
Q

Mediastinal disease is more prevalent in which type of lymphoma?

A

Hodgkin’s

18
Q

Why do substernal goiters become symptomatic?

A

Compression of surrounding structures, including heart and airway

19
Q

T/F: A median sternotomy is always needed to resect a substernal goiter?

A

FALSE

20
Q

What infectious diseases commonly present with mediastinal lymphadenopathy?

A

TB, histoplasmosis, coccidiomycosis

21
Q

T/F: Castleman’s disease (giant lymph node hyperplasia) can evolve into lymphoma

A

TRUE

22
Q

What is the most common type of mediastinal cyst?

A

Bronchogenic cyst

23
Q

What is the most common site for neurogenic tumors of the chest?

A

Posterior mediastinum along the paravertebral sulcus

24
Q

What is the primary treatment for neurogenic tumors?

A

Surgical excision