Mediastinal masses—transthoracic ultrasonography aspects

Superior vena cava syndrome (SVCS) often relates to malignant causes such as lung tumors, metastatic cancer, or lymphomas. While the diagnosis relies nowadays on the use of contrast-enhanced thoracic computed tomography, ultrasonography may have an important value as a first-line imaging technique, particularly when used in point-of-care office-based settings. Here, we report the case of a 67-year-old male presenting with SVCS in whom ultrasound contributed to diagnosis.

Section: General Advantages Of Usmentioning

confidence: 62%

Superior vena cava obstruction and mediastinal mass detected by point‐of‐care ultrasonography

Blanco¹,

Esteban²,

Leonardi³

2020

“…In the recent years, with the advancement of ultrasound technology, the diagnostic rate of space-occupying lesions by echocardiography has continuously improved. 4 Here, we report the case of a giant mediastinal teratoma first diagnosed by echocardiography, which clearly displayed its structure and location.…”

Section: Introductionmentioning

confidence: 85%

“…Structurally, the mediastinum is blocked by the sternum in front, and is obstructed by the air in the lungs on the sides, both of which creates hyper‐reflective interfaces precluding direct ultrasound examination. However, recent advances in ultrasound technology allow transthoracic echocardiography to clearly show the mediastinal structures surrounding the heart, substantially improving its diagnosis rate of mediastinal space‐occupying lesions . In order to clearly show the size and location of mediastinal masses and search for metastases, the parameters of the echocardiographic machine should be properly adjusted.…”

Section: Discussionmentioning

confidence: 99%

“…However, recent advances in ultrasound technology allow transthoracic echocardiography to clearly show the mediastinal structures surrounding the heart, 6 substantially improving its diagnosis rate of mediastinal space-occupying lesions. 4 In order to clearly show the size and location of mediastinal masses and search for metastases, the parameters of the echocardiographic machine should be properly adjusted. When necessary, the patient should hold her or his breath to reduce the negative effects of air in the lungs on the image quality.…”

Section: Discussionmentioning

confidence: 99%

“…However, transthoracic echocardiography has some advantages over X‐ray and CT in identifying mediastinal teratoma, including cost‐efficiency, convenience, noninvasiveness and nonradiation. In the recent years, with the advancement of ultrasound technology, the diagnostic rate of space‐occupying lesions by echocardiography has continuously improved . Here, we report the case of a giant mediastinal teratoma first diagnosed by echocardiography, which clearly displayed its structure and location.…”

Section: Introductionmentioning

confidence: 87%

See 2 more Smart Citations

Identification of a giant mediastinal teratoma by echocardiography: A case report

Duan

Tang

et al. 2019

The diagnosis of mediastinal space‐occupying lesions largely relies on X‐ray and computed tomography. However, thanks to technological progress, transthoracic echocardiography can clearly display the mediastinal structures surrounding the heart and great vessels, thereby improving the detection rate of mediastinal space‐occupying lesions. Primary mediastinal teratoma is relatively rare, and removal of giant mediastinal teratoma by thoracoscopic surgery has rarely been reported. Here, we report a case of giant mediastinal teratoma diagnosed by transthoracic echocardiography, which was treated by complete thoracoscopic resection and confirmed by histology.

Contrast‐enhanced ultrasound features of mediastinal lymphomas and thymic epithelial tumors

Kong

Yang

et al. 2019

Objectives: To summarize the contrast-enhanced ultrasound (CEUS) features of mediastinal lymphomas and thymic epithelial tumors (including thymomas and thymic carcinomas) and to explore the value of CEUS in the differential diagnosis of lymphomas and thymic epithelial tumors. Methods: Sixty-nine patients with 69 mediastinal lesions who underwent CEUS and had disease confirmed by histopathology were enrolled in the study. There were 33 cases of lymphoma, 19 cases of thymic carcinoma, and 17 cases of thymoma. CEUS features, including the enhancement pattern, enhancement distribution, enhancement time, inner necrosis status, wash out pattern, and vascular morphology, were evaluated in each group. Results: Thymomas often presented with homogeneous (88.2%, 15/17) and late (88.2%, 15/17) enhancement and a low rate of inner necrosis (17.6%, 3/17). Late (73.7%, 14/19), heterogeneous (68.4%, 13/19), and centripetal (63.2%, 12/19) enhancement were more often observed in thymic carcinoma, as was a high rate of inner necrosis (78.9%, 15/19). Lymphomas showed a homogeneous enhancement rate of 57.6% (19/33) and a late enhancement rate of 54.5% (18/33). The rate of inner necrosis for lymphomas was 45.5% (15/33). The diagnostic accuracy of thisfinding for distinguishing thymic epithelial tumors from lymphomas was 63.8%, the sensitivity was 80.6%, and the specificity was 45.5%. Enlarged blood vessels were a feature specific to lymphomas, while small vessels arranged in a comb shape was a feature specific to thymic epithelial tumors.Conclusion: This study describes the CEUS features of common mediastinal tumors and may stimulate further studies in this field.