Imaging modalities (MRI, CT, PET/CT), indications, differential diagnosis and imaging characteristics of cystic mediastinal masses: a review

Shah, Anoop; Rojas, Carlos Antônio Aguirre

doi:10.21037/med-22-31

Cited by 6 publications

(7 citation statements)

References 29 publications

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“…Well-defined homogeneous fluid-attenuating (0 to 20 HU) lesions in the prevascular mediastinum are of benign etiology including thymic and pericardial cysts [19,20]. These can be distinguished from one another based on their locations-thymic cysts are present in the thymic bed (Figure 3) and pericardial cysts are commonly located at the right cardiophrenic angle (Figure 4).…”

Section: Cystic Lesionsmentioning

confidence: 99%

“…Multilocular cystic lesions in the prevascular mediastinum may represent multilocular thymic cyst or lymphangioma. When multilocular cystic lesion with septations or soft tissue component extends to the neck, axilla or chest wall, the possibility of lymphangioma should be considered [20,21]. The presence of soft tissue component in the cystic lesion raises the possibility of malignancy with differentials including cystic teratoma or cystic thymoma (Figure 6).…”

Section: Cystic Lesionsmentioning

confidence: 99%

“…The soft tissue component may enhance with intravenous contrast administration [22][23][24]. extends to the neck, axilla or chest wall, the possibility of lymphangioma should be considered [20,21]. The presence of soft tissue component in the cystic lesion raises the possibility of malignancy with differentials including cystic teratoma or cystic thymoma (Figure 6).…”

Section: Cystic Lesionsmentioning

confidence: 99%

“…Typically, these lesions do not enhance but sometimes enhancement of the wall may be seen after gadolinium administration (Figure 15) [10,11,50]. Esophageal duplication cysts also manifest as a well-circumscribed homogeneous fluid attenuation lesion adjacent to the esophagus upon CT. Internal heterogeneity may be present due to hemorrhage or infection [20,50].…”

Section: Cystic Lesionsmentioning

confidence: 99%

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Approach to Imaging of Mediastinal Masses

Ahuja,

Strange,

Agrawal

et al. 2023

Diagnostics

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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 characterization of the mediastinal masses.

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Section: Cystic Lesionsmentioning

confidence: 99%

Section: Cystic Lesionsmentioning

confidence: 99%

Section: Cystic Lesionsmentioning

confidence: 99%

Section: Cystic Lesionsmentioning

confidence: 99%

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Approach to Imaging of Mediastinal Masses

Ahuja,

Strange,

Agrawal

et al. 2023

Diagnostics

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“…Dual-energy computed tomography with intravenous contrast can help distinguish cystic from solid lesions using digital iodine subtraction techniques (intravenous contrast). This allows differentiation of tissue enhancement from hemorrhagic/proteinaceous fluid, as well as differentiation of calcium due to different intensity of contrast accumulation [24].…”

Section: Introductionmentioning

confidence: 99%

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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