Analysis of mediastinal lesions: a study of 27 cases

Objective: The study was conducted to diagnose the mediastinal lesions/masses by computed tomographic on contrast enhanced scans and findings were compared with pathological diagnosis wherever possible. Methods:Contrast Enhanced Computed Tomography (CECT) of chest done in supine position in inspiration with 60 to 120 ml of 300 mg/ml of nonionic iodinated contrast and images were viewed in lung window (level 700 HU; width 1,500 HU), mediastinal window (level 30 HU-50 HU; width 350 HU-500 HU) and bone window (level 2,400 HU; width 200 HU). Results:The most common compartment to be involved was anterior mediastinum (38.3%) followed by posterior (16.7%), middle (13.3%) and superior mediastinum (11.7%) in that order. Predominant lesions were benign. The commonest lesion was tubercular lymphadenopathy (15%). Thymic masses and metastatic lymph node (26% each) were the most common mediastinal lesions in the anterior mediastinal compartment. Neural tumors (50%), esophageal carcinoma (37.5%) and thyroid masses (85.7%) were the common lesions in posterior, middle and superior mediastinal compartments respectively. Ascending aortic aneurysm was the predominant vascular lesion in our study (6.7%). Out of total 120 cases, 102 cases were histologically verified, six cases with hiatal hernia were confirmed with endoscopy while in 12 cases of vascular origin, and definitive diagnosis was established with Computed tomography (CT) scan alone. Conclusions:CT scan can distinguish specific tissue densities and its ability to display mediastinum in axial plane makes it a useful technique in the evaluation of a mediastinal mass.

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“…sixth decade of life. Our study is in concordance with Karki S et al [10] who showed in a study of 27 cases with mediastinal lesions that 18…”

Section: Discussionsupporting

confidence: 93%

Computed tomographic evaluation of mediastinal masses/lesions with contrast enhancement and correlation with pathological diagnosis – a study of 120 cases

Kaur¹,

Tiwari²,

Dugg

et al. 2014

JBGC

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“…The higher incidence of non-neoplastic patients is due to large number of patients diagnosed as 'suggestive of sarcoidosis' where they accounted for 43.4% of the patients. Karki and Chalise (2011) study findings agreed with our results where they observed a lower incidence of neoplastic patients. Similarly, Vaziri et al (2009) andPérez Dueñas et al (2010) reported that most of their patients were neoplastic, representing 60 and 78.6% of their patients, respectively.…”

Section: Discussionsupporting

confidence: 96%

Diagnostic role of fine needle aspiration cytology in mediastinal lymphadenopathy, with emphasis on subcarinal lymph nodes

El-Habashi¹,

Abusinna²,

Ezzat³

et al. 2014

Egyptian Journal of Pathology

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“…The age range and mean ages are very close to study by Biswajit Dubashi et al and another study by Karki and Chalise. 7,8 In this study, 91.6% of patients are symptomatic at presentation with the most common symptom being cough (87.5%) followed by chest pain (81.5%) and dyspnoea (79.1%). This is in accordance from a study by Davis, et al and Shrivastava et al, in which 85% of the patients with malignant mediastinal tumours were symptomatic.…”

Section: Discussionmentioning

confidence: 63%

Spectrum of malignant mediastinal masses at a tertiary care centre in Central India

et al. 2018

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Background: Malignant mediastinal masses can develop from structures that are normally located or pass through the mediastinum during development, as well as from metastases of malignancies that arise elsewhere in the body. Since many tumors that occur in the mediastinum are undifferentiated and have overlapping histologic features, one must consider a broad differential diagnosis and perform a thorough evaluation. This is particularly important since appropriate therapy for various mediastinal tumors differs considerably and may significantly impact survival.Methods: Ours was a retrospective descriptive study of 48 patients who presented or referred to medical oncology department from January 2014 to December 2017 and in whom malignant cause of mediastenal mass was established. All details of the patients pertinent epidemiology, clinical history and pathological including immunohistochemistry details were studied.Results: Out of 48 patients,14 cases (29.2%) were in adolescent and young adult age group (15-29 years). Majority of the patients were symptomatic (91.6%) with most common being cough (87.5%) followed by chest pain (81.5%) and dyspnoea (79.1%). Four of the patients presented with superior vena-caval syndrome. Most of the tumors (64.6%) are in anterior mediastenum region. Histopathological examination revealed non-hodgkins lymphoma in 31.25%, Hodgkins lymphoma in 18.75%, leukaemia in 6.25%, germ cell tumor in 8.33%, thymic neoplasms in 4.16%, neurogenic tumors in 4.16%, lung carcinoma in 10.4% and metastatic carcinoma in 10.4%.Conclusions: Malignant mediastinal masses have a broad range of diagnosis, establishing of which is important. While imaging help in narrowing the differential diagnosis, adequate pathological categorization should be done as many patients responds to specific line of therapy.

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Analysis of mediastinal lesions: a study of 27 cases

Cited by 17 publications

References 3 publications

Computed tomographic evaluation of mediastinal masses/lesions with contrast enhancement and correlation with pathological diagnosis – a study of 120 cases

Computed tomographic evaluation of mediastinal masses/lesions with contrast enhancement and correlation with pathological diagnosis – a study of 120 cases

Diagnostic role of fine needle aspiration cytology in mediastinal lymphadenopathy, with emphasis on subcarinal lymph nodes

Spectrum of malignant mediastinal masses at a tertiary care centre in Central India

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