THORACIC Section 15: Mediastinal Masses

Question 1

PA Dilatation vs Hilar mass

Answer 1

PA dilatation

Vessels converge into the lateral margin of the Bulky Hilum

Question 2

PA Dilatation vs Hilar mass

Answer 2

Hilar Mass (Hilum Overlay)

Question 3

Acquired Thymic cyst is due to

Answer 3

Thoracotomy, chemotherapy or HIV

Question 4

Thymic cyst on T2WI

Answer 4

Bright

Question 5

What makes thymoma more aggressive?

Answer 5

Calcifications

Question 6

Thymic carcinomas eat up the following structres:

Answer 6

Mediastinal fat and adjacent structures

Question 7

Average age for thymoma

Answer 7

50s

Question 8

Where does thymoma tend to “drop-mets”

Answer 8

Pleural
Retroperitoneum

Question 9

Tymoma disease associations

Answer 9

Myasthenia Gravis
Pure Red cell Aplasia
Hypogammaglobinemia

Question 10

Fatty thymic mass with interspersed soft tissue

Answer 10

Thymolipoma

Question 11

Most common Germ cell tumor

Answer 11

Teratoma (75%)

Question 12

Most common extragonadal germ cell tumor

Answer 12

Mediastinal teratoma

Question 13

Group age for Mediastinal Teratoma

Answer 13

<1 and 20s-30s

Question 14

This teratoma subtypes are exclusiveley seen in men

Answer 14

Immature

Question 15

What syndrome is the MATURE teratoma subtype associated with?

Answer 15

Klinefelter Syndrome

Question 16

Imaging features of Teratoma

Answer 16

Cystic appearance (90%) and fat
IF with calcifications, think teeth - GIVE AWAY!

Question 17

Uncommon and benign cyst in the right anterior cardiophrenic angle.

Answer 17

Pericardial cyst

Question 18

This is a proliferation of fibrous tissue that occurs within the mediastinum.

Answer 18

Fibrosing Mediastinitis (Sclerosis Mediastinitis)

Question 19

Two subtypes of Fibrosing Mediastinitis

Answer 19

1. Granulomatous
2. Non-Granulomatous

Question 20

This type of Fibrosing Mediastinitis is the one everyone thinks about that is classically caused by histioplasmosis.

Answer 20

Granulomatous Fibrosing Mediastinitis.

Question 21

Identify and describe

Answer 21

Granulomatous fibrosing mediastinitis

Soft tissue mass with calcifications infiltrating the normal fat planes of the mediastinum.

Question 22

A rare subtype of Fibrosing Mediastinitis is associated with retroperitoneal fibrosis

Answer 22

Non-Granulomatous

Question 23

This type of Fibrosing Mediastinitis lacks calcifications and enhances post contrast

Answer 23

Non-Granulomatous

Question 24

Fibrosing mediastinitis causes what type of syndrome?

Answer 24

Superior vena cava syndrome

Question 25

This congenital lesion are usually within the mediastinum

Answer 25

Bronchogenic cyst

Question 26

Common location of Bronchogenic cyst in the mediastinum

Answer 26

Subcarinal space

or intraparenchymal - less common

Question 27

A subcarinnal lesion obliterating the azygoesophageal line in CXR

Answer 27

Bronghogenic Cyst

Question 28

Abnormal lymph node size in the mediastinum

Answer 28

> 2cm

Question 29

Excess encapsulated fat seen in patients with iatrogenic steroid use, Cushings, and just plain old obesity

Answer 29

Mediastinal lipomatosis

Question 30

The most common posterior mediastinal mass.

Answer 30

Neurogenic tumors

Question 31

What are the neurogenic tumors in the mediastinum?

Answer 31

Schwannomas
Neurofibromas
Malignant peripheral nerve sheath tumors

Question 32

What is the response when bone marrow fails to respond to EPO?

Answer 32

Extramedullary hematopoiesis.