Mediastinal Masses Flashcards
What are the boundaries of the mediastinum?
Thoracic inlet superiorly, diaphragm inferiorly, pleural space to pleural space laterally, and sternum anteriorly to thoracic spine posteriorly
What are the three compartments of the mediastinum?
Anterosuperior, middle, and posterior
What is the border between the anterosuperior and middle mediastinum
Anterior pericardium
What is the border between the middle and posterior mediastinum?
Anterior border of vertebral bodies
What lab tests should be sent in patients with anterior mediastinal masses?
AFP, beta-HCG, LDH
What tumors are associated with increased levels of AFP and beta-HCG?
Non-seminomatous malignant germ cell tumors
What is the most common isolated anterior mediastinal tumor?
Thymoma
T/F: FNA or core needle bx of thymomas are often non-diagnostic?
TRUE
What approach should be used to resect a thymoma?
Median sternotomy
How should locally advanced (stage III) thymomas be treated?
Chemo, followed by surgery and adjuvant radiation
What paraneoplastic syndrome is associated with thymomas?
Myasthenia gravis
What are the two classifications of germ cell tumors?
Seminomas and non-seminomatous germ cell tumors
What is the definition of a teratoma?
Disorganized elements from all three germinal layers (ectoderm, mesoderm, endoderm)
Which germ cell tumor has surgery as its primary treatment?
Benign mediastinal teratomas
What is the primary treatment for seminomas?
XRT
T/F: FNA samples are sufficient for diagnosis of lymphoma.
FALSE
Mediastinal disease is more prevalent in which type of lymphoma?
Hodgkin’s
Why do substernal goiters become symptomatic?
Compression of surrounding structures, including heart and airway
T/F: A median sternotomy is always needed to resect a substernal goiter?
FALSE
What infectious diseases commonly present with mediastinal lymphadenopathy?
TB, histoplasmosis, coccidiomycosis
T/F: Castleman’s disease (giant lymph node hyperplasia) can evolve into lymphoma
TRUE
What is the most common type of mediastinal cyst?
Bronchogenic cyst
What is the most common site for neurogenic tumors of the chest?
Posterior mediastinum along the paravertebral sulcus
What is the primary treatment for neurogenic tumors?
Surgical excision
