Fine-needle aspiration of the mediastinum: A clinical, radiologic, cytologic, and histologic study of 42 cases

Abstract

Forty‐two fine‐needle aspirates (FNA) of the mediastinum were reviewed from 1984–1995. The clinical, radiologic, pathologic, and cytologic material was studied. Twenty‐five males and 17 females had an age range from 10–72 yr and a mean of 41 yr. Common complaints were chest pain, dyspnea, and cough. Thirty‐eight tumors were in the anterior/superior mediastinum. Fifty‐seven percent were primary neoplasms (Hodgkin's lymphoma, 7; non‐Hodgkin's lymphoma, 6; thymoma, 3; germ‐cell tumor, 3; thymic carcinoid and angiosarcoma, 1 each; and malignant not otherwise specified, 3). Twenty‐four percent were metastatic tumors (carcinoma, 9; and sarcoma, 1). Twelve percent were benign conditions (granulomatous disease, 2; multinodular goiter, 1; extramedullary hematopoesis, 1; and one thymic cyst). Seven percent were inconclusive. FNA yielded adequate tissue for diagnosis in 83% and a correct diagnosis in 86%. There was one false‐negative and no false‐positive diagnosis. FNA is a useful tool for accurate tissue diagnosis of mediastinal masses. Diagn. Cytopathol. 1998;19:428–436. © 1998 Wiley‐Liss, Inc.

Diagnostic evaluation of mediastinal lesions: Analysis of 144 cases

“…[1] The likelihood of malignancy is influenced by several factors that include the location of the lesion, age of the patient, and presence or absence of symptoms. [12] The malignant mediastinal lesions are mostly seen at the anterior mediastinum, in patients having symptoms and with the advanced age.…”

“…This observation is in contrast to the study by Shabb et al . [1] and Karki and Chalise.,[10] where primary mediastinal lesions were more common than metastatic lesions. Studies conducted by Adler et al .…”

“…It is being a site for both nonneoplastic and neoplastic lesions, benign and malignant, primary and metastatic, many of them present as mediastinal masses. [1]…”

The diagnostic value of image guided percutaneous fine needle aspiration biopsy in equivocal mediastinal masses

“…In cases which cytopathology gives limited information, cytologic findings may lead clinicians to go one step further for tissue biopsy such as in lymphoma cases. In these cases, adequate tissue should be obtained by core or open biopsy in order to make the lesion's subclassification [2,3].…”

“…Even in cases in which the diagnosis is obvious, a surgical biopsy was needed for confirmation and/or subclassification. Besides, for HL cases, the treatment should not be based on cytological diagnosis alone especially in newly diagnosed patients [2,3]. If the cytologic diagnosis is suggestive of lymphoma, further tissue biopsies (core or excisional) should be performed to obtain adequate specimen for ancillary studies necessary for histological confirmation.…”