Diagnosis of Mediastinal Masses

LeBlanc, Johanne; Wood, Douglas E.

doi:10.1007/978-3-642-79426-1_1

Cited by 3 publications

(5 citation statements)

References 31 publications

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“…Features suggestive of malignancy include vascular invasion, encasement, and pleural deposits. 13 Surgical excision then provides the precise histology and staging information necessary to render a decision regarding the appropriateness of postoperative (adjuvant) treatment. Small, encapsulated, ''typical'' thymomas are excised for diagnosis and treatment.…”

Section: Diagnostic Work-upmentioning

confidence: 99%

“…The most common tumors one must include in the differential diagnosis of an anterior mediastinal tumor are lymphomas and germ cell tumors. 13 Lymphomas usually have a characteristic CT appearance, including an ill-defined lobulated mass, often with associated regional or distant lymphadenopathy. 16 Flow cytometry is useful in distinguishing lymphoma from thymoma.…”

Section: Diagnostic Work-upmentioning

confidence: 99%

See 1 more Smart Citation

Thymoma: State of the Art

Thomas

Wright

Loehrer

1999

JCO

279

177

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Thymoma is the most common tumor of the anterior mediastinum. This tumor is associated with unique paraneoplastic syndromes, such as myasthenia gravis, hypogammaglobulinemia, and pure red cell aplasia. The rarity of this tumor, however, has somewhat obscured the optimal treatment for this disease. For the majority of patients who present with localized tumor, surgical extirpation remains the standard of choice. Adjuvant radiotherapy seems to improve local control and survival. In more advanced disease, systemic therapy has been demonstrated to produce a 50% to 80% objective response rate. These observations have led to the development of multimodality therapy for the treatment of patients with advanced thymoma. In this article, we will review the current perspectives on the management of early stage and advanced thymoma.

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Section: Diagnostic Work-upmentioning

confidence: 99%

Section: Diagnostic Work-upmentioning

confidence: 99%

Thymoma: State of the Art

Thomas

Wright

Loehrer

1999

JCO

279

177

View full text Add to dashboard Cite

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“…The most common tumors that the clinician must include in the differential diagnosis of an anterior mediastinal tumor are lymphomas and germ cell tumors [11, 12]. …”

Section: Discussionmentioning

confidence: 99%

“…The diagnostic work-up after CT scan usually includes surgical excision, which provides the precise histological and staging information necessary for the next therapeutic steps. The most common tumors that the clinician must include in the differential diagnosis of an anterior mediastinal tumor are lymphomas and germ cell tumors [ 11 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Respiratory Distress due to Thymoma in a Patient Treated with TK Inhibitor: A Case Report and Review of the Current Treatment Options

Matthaios¹,

Iordanidis

Zervas

et al. 2011

Case Rep Oncol

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Thymic malignancies are rare intrathoracic tumors that may be aggressive and difficult to treat in advanced stage. Surgery is the cornerstone of the management of thymomas: it is significant for the definite histopathological diagnosis and staging, and in most cases, it constitutes the first step of the treatment strategy. For patients with primary unresectable thymomas, the multimodal treatment schedule nowadays includes neoadjuvant chemotherapy, extensive surgery, adjuvant radiotherapy, and in some cases, adjuvant chemotherapy. A patient with a history of stage III COPD and an undiagnosed thoracic mass was admitted to the intensive care unit with acute respiratory distress. A radiologic evaluation by CT scan revealed a mass of 13 cm in diameter at the mediastinum. Fine needle aspiration was performed and revealed a thymoma. Due to poor performance status, the patient was not able to undergo surgery. He refused to be treated with neither chemotherapy nor radiotherapy, but due to EGFR overexpression, treatment with TK inhibitor was suggested. Fine needle aspiration biopsy is commonly used to identify metastasis to the mediastinum. However, it is less often employed as a primary diagnostic tool for tumors, particularly thymic neoplasms. The use of targeted therapies for the treatment of thymic malignancies has been described in the literature. Over the past years, significant efforts have been made to dissect the molecular pathways involved in the carcinogenesis of these tumors. Insights have been obtained following anecdotal clinical responses to targeted therapies, and large-scale genomic analyses have been conducted.

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“…Mediastinal tumours are usually located anteriorly in the mediastinum (1). The most common tumour types in the anterior mediastinum are malignant lymphoma, thymoma, goitre, germ cell tumour or lymph node metastasis.…”

Section: Original Articlementioning

confidence: 99%

Value of Transsternal Core Biopsy in Patients with a Newly Diagnosed Mediastinal Mass

Hagberg

Åhlström²,

Magnusson³

et al. 2000

Acta Oncologica

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Histopathologic analysis of an anterior mediastinal mass of unknown origin is essential for treatment decision. Mediastinoscopy is the most common procedure performed to obtain biopsies, but general anaesthesia and hospitalization are necessary. The aim of this study was to evaluate whether transsternal core biopsies, an easy outpatient biopsy technique, could be an alternative to mediastinoscopy. A biopsy instrument that makes it possible to reach tumours hidden behind bone was used for transsternal CT-guided core biopsies in 21 patients with a newly diagnosed anterior mediastinal mass. No severe side effects were observed. In 19/21 (90%) patients the biopsies were diagnostic. In 2/21 patients additional biopsy techniques had to be used. In these two patients Hodgkin's disease was suspected in the first biopsy procedures. The diagnosis was confirmed by new core biopsies, from other parts of the tumour, not using a transsternal approach (transclavicular and parasternal, respectively). In addition, one mediastinoscopy was performed in a patient who was diagnosed with a non-Hodgkin's lymphoma but where more material was needed for lymphoma subclassification. It is concluded that CT-guided transsternal core biopsy is a clinically valuable method in patients with a newly diagnosed anterior mediastinal mass.

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Diagnosis of Mediastinal Masses

Cited by 3 publications

References 31 publications

Thymoma: State of the Art

Thymoma: State of the Art

Acute Respiratory Distress due to Thymoma in a Patient Treated with TK Inhibitor: A Case Report and Review of the Current Treatment Options

Value of Transsternal Core Biopsy in Patients with a Newly Diagnosed Mediastinal Mass

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