Pleural and mediastinal disease 2 Flashcards
What is atelectasis?
The collapse or incomplete expansion of alveolar air spaces
What is the pathogenesis of atelectasis?
(1) Obstruction
(2) Compression
What are the causes of pleural effusions?
6
(1) Noninflammatory
(a) congestive heart failure
(b) rupture aortic aneurysm
(2) Inflammatory
(a) bacterial infections
(b) collagen vascular diseases
What are the causes of pleuritis?
6
(1) Bacterial infections
(2) Rheumatoid arthritis
(3) Lupus erythematosis
(4) Uremia
(5) Radiation therapy
(6) Pulmonary infarcts
What is empyema?
3
(1) Complication of pneumonia with pleural abscess formation
(2) Infection spreads to pleural cavity
(3) Leads to bacteremic dissemination and pleural fibrosis
What are the diseases of the mediastinum?
5
(1) Lymphoma
(2) Thymoma
(3) Mediastinal germ cell tumors
(4) Carcinoid tumors
(5) Posterior mediastinum tumors
What is the mediastinum anatomically bounded by?
5
(1) Thoracic inlet superiorly
(2) Diaphragm inferiorly
(3) Sternum anteriorly
(4) Spine posteriorly
(5) Pleura laterally
What are the tumors of the anterior mediastinum?
6
(1) Thymoma
(2) Lymphoma
(3) Germ cell tumor
(4) Carcinoid
(5) Metastatic carcinoma
(6) Lipoma
What are the tumors of the middle mediastinum?
2
(1) Sarcoma of the heart and pleura
(2) Lymphoma
What are the tumors of the posterior mediastinum?
3
(1) Neural tumors: (a) schwannoma and (b) neurofibroma
(2) Ganglioneuroblastoma
What are the symptoms of thymoma?
6
(1) Cough
(2) Dyspnea
(3) Chest pain
(4) Dysphagia
(5) Hoarseness
(6) Stridor
What are the characteristics of thymoma?
2
(1) Thymoma has a dense fibrous capsule
2) Tumor is composed of epithelial cells and lymphocytes (lymphocytes are benign component of tumor
What are the classifications of thymomas?
3
(1) Typical thymoma - usually benign but may behave aggressively
(2) Atypical thymoma - indeterminate
(3) Thymic carcinoma - malignant and aggressive
What are the characteristics of typical thymoma?
3
(1) Small and uniform tumor
(2) No necrosis or hemorrhage
(3) No invasion of capsule by tumor
What are the characteristics of thymic carcinoma?
3
(1) Large tumor
(2) Areas of necrosis and hemorrhage
(3) Invasion of tumor through capsule
How are thymoma and Myasthenia Gravis related?
(1) Myasthenia gravis is an acquired autoimmune disorder resulting in acetylcholine receptor deficiency
(2) 65% of patients with MG have thymic lymphoid hyperplasia
(3) 15% of patients with MG have thymoma
(4) Tumors tend to behave less aggressively with MG
What are the characteristics of mediastinal germ cell tumors?
(3)
(1) Most germ cell tumors arise in gonadal tissue
(2) Comprise 10% of anterior mediastinal tumors
(3) Marked male predominance
(4) Elevated HCG/AFP (human chorionic gonadotropin/α-fetoprotein)
What are the classifications of mediastinal germ cell tumors?
(3)
(1) Benign - teratoma (mixed tumor elements)
(2) Seminoma - malignant
(3) Non-seminomatous tumors - malignant, high-grade
What is thymic carcinoid?
4
(1) Rare mediastinal tumor
(2) Aggressive neoplasms that commonly invade locally to adjacent mediastinal structures
(3) Metastasize to regional lymph nodes
(4) Behave aggressively
