Mediastinal Masses Flashcards
1
Q
Causes of mediastinal masses
A
-developmental, neoplastic, infectious, traumatic, cardiovascular
2
Q
Most mediastinal masses are located in anterior, middle or posterior mediastinum?
A
-Anterior or middle compartment!
3
Q
Differential diagnosis for anterior mediastinal mass
A
- thymoma
- teratoma
- thyroid lesions
- lymphoma
- mesenchymal tumors (lipoma, fibroma)
4
Q
Differential diagnosis of a middle mediastinal mass
A
- lymphadenopathy
- pulmonary artery enlargement
- aneurysm of aorta or innominate artery
- developmental cyst (bronchogenic, enteric, pleuropericardial)
- dilated azygous or hemizygous vein
- Foramen of Morgagni hernia
5
Q
Differential diagnosis of posterior mediastinal mass
A
- hiatal hernia
- neurogenic tumor
- meningocele
- esophageal tumor
- foramen of Bochdalek hernia
- thoracic spine disease
- extramedullary hematopoiesis
6
Q
Neurogenic tumors
A
- neurilemmoma
- neurofibroma
- neurosarcoma
- ganglioneuroma
- pheochromocytoma
7
Q
Signs and symptoms of mediastinal masses
A
- nonspecific
- caused by effects of mass on surrounding structures
- insiduous onset of retrosternal chest pain, dysphagia, or dyspnea
- half cases–asymptomatic
- mass detected on chest x-ray
8
Q
Managing Mediastinal masses
A
- CT scan helpful
- barium swallow if esophageal disease is suspected, Doppler sonography or venography of brachiocephalic veins and superior vena cava and angiography
- MRI useful–better delineation of hiliar structures and distinction between vessels and masses; also shows images in multiple planes whereas CT permits only axial imaging
9
Q
When is tissue diagnosis necessary for mediastinal tumors?
A
-when neoplastic disorder is suspected
10
Q
Treatment and prognosis for mediastinal masses
A
depend on underlying cause of mediastinal mass
