MEDIASTINUM AND HILA

Question 1

Focal Mediastinal Enlargement

Answer 1

Common:

• Lymphadenopathy
• Aneurysm
• Thyroid Goiter
• Pericardial cyst

Less Common:

• Foregut cyst
• Thymic cyst
• Thymic malignancy
• Neurogenic neoplasm

Rare:

• Mature teratoma
• Extra-medllary hematopoi

Question 2

Diffuse mediastinal enlargement

Answer 2

• Malignancy:
  
  • lung
  • Lymphoma
  • Germ Cell tumour
  • Thymic tumour
  • Sarcoma
• Medastinal lymphadenopathy
• Lipomatosis
• Lymphangioma
• Castlemans disease

Question 3

Anterior mediastinal mass

Answer 3

• Thymus: thymoma, hyperplasia, cyst, carcinoma, carcinoid
• Thyroid: goiter
• Germ Cell tumour:
  
  • Seminomatous
  • Non-seminomatous
  • Mature Teratoma
• Metastatic disease
• Lymphoma
• Other:
  
  • Lipomatosis
  • Lipoma
  • Liposarcoma
  • Ectopic parthyroid adenoma
  • lymphangioma

Question 4

Middle Mediastinal Compartment

Answer 4

• Lymphadenopathy
• Neoplasms:
  
  • Esophageal/tracheal neoplasms
  • Lymphoma
  • Metastatic disease
• Sarcoidosis
• Foregut duplicaiton cysts
• Hiatus hernia
• Infection: mediastinitis
• Thyroid goiter
• Lipomatosis
• Hemorrhage
• Aneruysm

Question 5

Posterior mediastinal Mass

Answer 5

• Neoplasms:
  
  • Neurogenic tumours:
    
    • Peripheral nerve sheath tumour
    • Sympathetic ganglion tumor
  • Lymphoma
  • Esophageal malignancy
  • Metstatic disease
• Infection/abscess
• Forgut duplication cyst
• Lateral thoracic meningocoele
• Extramedullary hematopoiesis
• Other: hemangioma, lymphangioma, pancreatic pseudocyst.

Question 6

Cardiophrenic angle mass

Answer 6

• Epicardial fat pad
• Pericardial cyst
• Morgagni hernia
• Lymphadenopathy
• Thymoma
• Mediastinal fat necrosis
• Fibrous tumor of pleura
• Impending cardiac volvulus

Question 7

Azygoesophageal recess lesion

Answer 7

• Lymphadenopathy
• Hiatus hernia
• Esophageal cancer
• Left atrial enlargement
• Foregut duplication cyst
• Para-esophageal varices

Question 8

Pneumomediastinum

Answer 8

• Spontaneous pneumomediastinum
• Tracheobronchial injury
• Esophageal perforation
• Mediastinitis

Question 9

Hilum overlay sign

Answer 9

Anteiror mediastinum:

• Thyroid
• Thymus: thymoma, hyperplasia, carcinoma, cyst
• Lymphoma
• Germ Cell tumour
• Metastatic disease

Posterior mediastinum:

• Neoplasm: neurogenic, esophageal tumor, lymphoma, metastatic
• Infection/abscess
• Foregut duplication cyst
• Lateral thoracic meningocoele
• Extramedullary hematopoesis

Question 10

Fat Containing Mediastinal Lesion

Answer 10

• Mature teratoma
• Thymolipoma
• Thymic hyperplasia
• Lipoma
• Liposarcoma
• Malignant teratoma
• Extramedullary hematopoesis

Question 11

Cystic Mediastinal Mass

Answer 11

• Foregut duplication cyst
• Thyroid goiter
• Pericardial cyst
• Thymic cyst
• Necrotic lymph node: infection, malignancy
• Necrotic/cystic neoplasm: Germ-Cell tumours, thymic tumours
• Lateral throcic meningocoele
• Infection/abscess
• Lymphangioma

Question 12

Mediastinal Calcification

Answer 12

• Sarcoidosis
• Histoplasmosis
• Cardiovascular calcification
• Mediastinal goiter
• Pneumoconiosis
• Mediastinal fibrosis
• Treated Lymphoma
• Metastatic disease
• Congenital cyst