THORACIC Section 15: Mediastinal Masses Flashcards
PA Dilatation vs Hilar mass
PA dilatation
Vessels converge into the lateral margin of the Bulky Hilum
PA Dilatation vs Hilar mass
Hilar Mass (Hilum Overlay)
Acquired Thymic cyst is due to
Thoracotomy, chemotherapy or HIV
Thymic cyst on T2WI
Bright
What makes thymoma more aggressive?
Calcifications
Thymic carcinomas eat up the following structres:
Mediastinal fat and adjacent structures
Average age for thymoma
50s
Where does thymoma tend to “drop-mets”
Pleural
Retroperitoneum
Tymoma disease associations
Myasthenia Gravis
Pure Red cell Aplasia
Hypogammaglobinemia
Fatty thymic mass with interspersed soft tissue
Thymolipoma
Most common Germ cell tumor
Teratoma (75%)
Most common extragonadal germ cell tumor
Mediastinal teratoma
Group age for Mediastinal Teratoma
<1 and 20s-30s
This teratoma subtypes are exclusiveley seen in men
Immature
What syndrome is the MATURE teratoma subtype associated with?
Klinefelter Syndrome
Imaging features of Teratoma
Cystic appearance (90%) and fat
IF with calcifications, think teeth - GIVE AWAY!
Uncommon and benign cyst in the right anterior cardiophrenic angle.
Pericardial cyst
This is a proliferation of fibrous tissue that occurs within the mediastinum.
Fibrosing Mediastinitis (Sclerosis Mediastinitis)
Two subtypes of Fibrosing Mediastinitis
- Granulomatous
- Non-Granulomatous
This type of Fibrosing Mediastinitis is the one everyone thinks about that is classically caused by histioplasmosis.
Granulomatous Fibrosing Mediastinitis.
Identify and describe
Granulomatous fibrosing mediastinitis
Soft tissue mass with calcifications infiltrating the normal fat planes of the mediastinum.
A rare subtype of Fibrosing Mediastinitis is associated with retroperitoneal fibrosis
Non-Granulomatous
This type of Fibrosing Mediastinitis lacks calcifications and enhances post contrast
Non-Granulomatous
Fibrosing mediastinitis causes what type of syndrome?
Superior vena cava syndrome
This congenital lesion are usually within the mediastinum
Bronchogenic cyst
Common location of Bronchogenic cyst in the mediastinum
Subcarinal space
or intraparenchymal - less common
A subcarinnal lesion obliterating the azygoesophageal line in CXR
Bronghogenic Cyst
Abnormal lymph node size in the mediastinum
> 2cm
Excess encapsulated fat seen in patients with iatrogenic steroid use, Cushings, and just plain old obesity
Mediastinal lipomatosis
The most common posterior mediastinal mass.
Neurogenic tumors
What are the neurogenic tumors in the mediastinum?
Schwannomas
Neurofibromas
Malignant peripheral nerve sheath tumors
What is the response when bone marrow fails to respond to EPO?
Extramedullary hematopoiesis.
