Approach to Imaging of Mediastinal Masses

Ahuja, Jitesh; Strange, Chad D.; Agrawal, Rishi; Erasmus, Lauren T.; Truong, Mylene T.

doi:10.3390/diagnostics13203171

Diagnostics

2023

DOI: 10.3390/diagnostics13203171

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Approach to Imaging of Mediastinal Masses

Jitesh Ahuja,

Chad D. Strange,

Rishi Agrawal

et al.

Abstract: Mediastinal masses present a diagnostic challenge due to their diverse etiologies. Accurate localization and internal characteristics of the mass are the two most important factors to narrow the differential diagnosis or provide a specific diagnosis. The International Thymic Malignancy Interest Group (ITMIG) classification is the standard classification system used to localize mediastinal masses. Computed tomography (CT) and magnetic resonance imaging (MRI) are the two most commonly used imaging modalities for… Show more

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2024

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Cited by 3 publications

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Pathomorphological features of confirmed bronchogenic cyst with atypical localization

Khoroshun,

Nehoduiko,

Vorovskyi

et al. 2024

Rep. of Morph.

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Among all formations of the mediastinum in the adult population, cysts make up about 20 %, of which more than 60 % are bronchogenic cysts, where up to 50% have an asymptomatic course, and therefore in most cases are detected accidentally. Regardless of the course and origin, cysts are subject to complete surgical removal. In connection with the clinical and radiological polymorphism of bronchogenic cysts, histological confirmation of the origin of the cysts does not lose its relevance. The purpose of the work is to study and highlight the pathomorphological characteristics of a cyst localized in the pericardium. Using video-assisted thoracic surgery (VATS) and thoracotomy approaches, 16 people aged 28 to 62 with cystic lesions of the mediastinum were operated on. The patients underwent radiographic examination, computed tomography with intravenous contrast injection and, in 2 cases, magnetic resonance imaging. Ultrasound examination was performed on 6 patients in whom cystic lesions were a diagnostic finding. The location of the cyst, maximum diameter, density, and calcification were evaluated. Clinically and radiologically, asymptomatic pericardial (coelomic) cysts were detected in 2 persons in the prevascular department. In the visceral part of the mediastinum, 3 patients had a pericardial cyst, 10 patients were diagnosed with 10 bronchial cysts with parenchymal and perihilar localization, among which one patient was diagnosed with an asymptomatic bronchial cyst with an atypical localization in the pericardium. In the paravertebral part of the mediastinum, 1 paraesophageal cyst was established, which was intimately connected with the lower third of the thoracic part of the esophagus. All types of cysts were histologically confirmed. Statistical processing of the obtained results was carried out using the Excel program. After a clinical examination of a patient with a pericardial cyst of the visceral mediastinum, right VATS surgery and removal of the cyst was performed. Histological examination of fragments of the cyst wall showed the presence of multi-rowed ciliated cylindrical epithelium, pronounced infiltration by lymphoid elements with hemorrhages and foci of fibrotization in separate areas. The histological structure of the removed pericardial cyst confirmed its bronchogenic origin. So, we discovered a rare form of abnormality of embryonic growth of the ventral part of the foregut with localization of a bronchogenic cyst in the anterior-inferior mediastinum on the right, which significantly expanded the understanding of the disease.

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Pathomorphological features of confirmed bronchogenic cyst with atypical localization

Khoroshun,

Nehoduiko,

Vorovskyi

et al. 2024

Rep. of Morph.

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The Clinico-pathology Loci, Diagnosis and Management of Mediastinal Masses: A Retrospective Study in a Tertiary Care Hospital

Roy,

Biswas,

Roy

2024

Bengal Physician Journal

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Left Atrial Compression by an Intramural Hematoma: A Rare Case of Obstructive Shock

Dividis,

Pallas,

Karageorgiou

et al. 2024

Cureus

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A 3.5 cm diameter descending aorta focal aneurysm was incidentally found when a computed tomography (CT) was conducted due to persistent pyrexia in an 85-year-old woman hospitalized for a non-obstructive urinary tract infection. Ten days later, whilst fever subsided and inflammation markers decreased, she became hypoxic. CT revealed an aortic intramural hematoma (Stanford type B) increasing the diameter of the thoracic aorta aneurysm to 6.5 cm. A thoracic endovascular aortic repair (TEVAR) surgery was performed. Seven days after the operation she developed respiratory and hemodynamic compromise. CT depicted further enlargement of the aortic intramural hematoma, increasing the aortic diameter to 8 cm. Transthoracic echocardiography provided valuable information showing extrinsic compression of the left atrium and left ventricle inflow obstruction provoking obstructive shock.

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Approach to Imaging of Mediastinal Masses

Cited by 3 publications

References 63 publications

Pathomorphological features of confirmed bronchogenic cyst with atypical localization

Pathomorphological features of confirmed bronchogenic cyst with atypical localization

The Clinico-pathology Loci, Diagnosis and Management of Mediastinal Masses: A Retrospective Study in a Tertiary Care Hospital

Left Atrial Compression by an Intramural Hematoma: A Rare Case of Obstructive Shock

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