Primary Tumors of the Mediastinum

Benjamin, Sanford P.; McCormack, Lawrence J.; Effler, Donald B.; Groves, Laurence K.

doi:10.1378/chest.62.3.297

Cited by 123 publications

(31 citation statements)

References 14 publications

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“…Thymic masses constitute 14% of cases which is comparable to study conducted by Kiran et al and Dutta et al [13] Thyroid masses constitute 10% of cases which is comparable to study by Benjamin et al [14] Lymphomas constitute 18% of mediastinal masses which is comparable to study by Benjamin et al and Cohen et al [15] Germ cell tumors and neurogenic tumors constitute 4% and 8% of cases which is comparable to study by Dutta et al…”

Section: Discussionsupporting

confidence: 81%

Computed Tomographic Evaluation of Mediastinal Masses

Shashikumar¹,

L²,

Nanjaraj³

et al. 2015

jemds

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OBJECTIVES:The objectives of our study being categorization of the masses according to the mediastinal compartments, study their CT characteristics and to compare the CT findings with histopathological findings. MATERIALS AND METHODS: Patients who were suspected to have a mediastinal mass either on clinical examination or on the basis of an abnormal chest radiograph. Thorough clinical history and clinical examination of the patients was done before CT examination. The images were studied in mediastinal, lung and bone window settings. Biopsy of the masses was taken wherever possible. RESULTS: Our study included a total of 50 cases, 31males and 19 females. Cough (n=35, 70%) and dyspnoea (n=28, 46%) were the major presenting complaints. Anterior mediastinum (n=15, 39.4%) is the most commonly involved compartment followed by posterior mediastinum (n=12, 31.5%) and middle mediastinum (n=11, 28.9%). Trans compartmental involvement is more commonly seen involving the anterior and middle mediastinum. The majority of the mediastinal masses are well defined (n=36, 72%), with soft tissue (n=34, 68%) attenuation on plain CT, showing heterogeneous enhancement (n=22, 44%) on contrast study. Masses involved the adjacent structures in 48% cases (n=24) and associated lung findings and bony changes were seen in 64% (n=32) and 14% cases (n=7) respectively. CONCLUSION: To conclude, CT is an important modality in the evaluation of mediastinal masses for their exact localization, analyzing their morphology and arriving at a provisional diagnosis for optimal patient management.

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Section: Discussionsupporting

confidence: 81%

Computed Tomographic Evaluation of Mediastinal Masses

Shashikumar¹,

L²,

Nanjaraj³

et al. 2015

jemds

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“…Malignant lesions were majority in our study. Benjamin et al examined 215 patients with mediastinal masses over a 20-year period, among which 60% were benign and 40% were malignant [1]. In a study by Murray et al on 132 patients, 85% were malignant and 15% were benign mediastinal masses [2].…”

Section: Discussion and Resultsmentioning

confidence: 99%

Multidetector Computed Tomography Evaluation of Mediastinal Lesions with Histopathological Diagnosis

Arumugam¹,

Nazir²,

Rajasekar³

2015

OJRD

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The evaluation of mediastinal abnormalities is a challenging radiographical problem. Crosssectional imaging of the mediastinum by computed tomography now demonstrates precise anatomic details and is the imaging modality of choice for most mediastinal lesions. The following study was undertaken with the objectives of determining the mediastinal lesions affecting the mediastinum and to correlate the computed tomography findings with the histopathology reports. In this study, 50 patients clinically suspected with mediastinal mass lesions or who had chest radiograph with a suspicious mediastinal lesion were evaluated from October 2013 to September 2014. In our study, we used varying computed tomography features of each mediastinal pathology types to predict a histological diagnosis of mediastinal lesions. Most of the lesions could be predicted with good sensitivity, specificity and diagnostic accuracy.

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“…(16)(17)(18) Lymphomas have been included even in studies that selected patients submitted to surgical resection of malignant mediastinal tumors, p = 0.04). The number of censored cases at 20, 40 and 60 months, respectively, was as follows: complete resection: 16, 8 and 4 patients; and incomplete resection: 5, 4 and 3 patients.…”

Section: Discussionmentioning

confidence: 99%

Characteristics associated with complete surgical resection of primary malignant mediastinal tumors

et al. 2009

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Objective: To identify preoperative characteristics associated with complete surgical resection of primary malignant mediastinal tumors. Methods: Between 1996 and 2006, 42 patients with primary malignant mediastinal tumors were submitted to surgery with curative intent at a single facility. Patient charts were reviewed in order to collect data related to demographics, clinical manifestation, characteristics of mediastinal tumors and imaging aspects of invasiveness. Results: The surgical resection was considered complete in 69.1% of the patients. Cases of incomplete resection were attributed to invasion of the following structures: large blood vessels (4 cases); the superior vena cava (3 cases); the heart (2 cases); the lung and chest wall (3cases); and the trachea (1 case). Overall survival was significantly better among the patients submitted to complete surgical resection than among those submitted to incomplete resection. The frequency of incomplete resection was significantly higher in cases in which the tumor had invaded organs other than the lung (as identified through imaging studies) than in those in which it was restricted to the lung (47.6% vs. 14.3%; p = 0.04). None of the other preoperative characteristics analyzed were found to be associated with complete resection. Conclusions: Preoperative radiological evidence of invasion of organs other than the lung is associated with the incomplete surgical resection of primary malignant mediastinal tumors.Keywords: Thoracic surgery; Survival rate; Mediastinal neoplasms; Diagnostic imaging. ResumoObjetivo: Identificar características pré-operatórias associadas à ressecção cirúrgica completa de tumores malignos primários do mediastino. Métodos: Entre os anos de 1996 e 2006, 42 pacientes com tumores malignos primários do mediastino foram submetidos a tratamento cirúrgico com intenção curativa em uma única instituição. Dados demográficos, manifestações clínicas, características do tumor mediastinal e aspectos de invasão por métodos de imagem foram identificados através da análise de prontuários. Resultados: A ressecção cirúrgica foi considerada completa em 69,1% dos pacientes. As causas de ressecção incompleta foram atribuídas à invasão das seguintes estruturas: grandes vasos (4 casos); veia cava superior (3 casos); coração (2 casos); pulmão e parede torácica (3 casos); e traqueia (1 caso). Os pacientes que foram submetidos à ressecção cirúrgica completa tiveram sobrevida global significativamente melhor que os pacientes submetidos à ressecção incompleta. A frequência de ressecção incompleta foi significativamente maior nos casos nos quais foram identificadas características radiológicas de invasão de outros órgãos além do pulmão do que nos casos cujas características eram restritas ao pulmão (47,6% vs. 14,3%; p = 0,04). Nenhuma das outras características pré-operatórias analisadas foi associada com a ressecção cirúrgica completa. Conclusões: Evidências radiológicas de invasão de órgãos além do pulmão no pré-operatório estão associadas à ressecção cirú...

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Primary Tumors of the Mediastinum

Cited by 123 publications

References 14 publications

Computed Tomographic Evaluation of Mediastinal Masses

Computed Tomographic Evaluation of Mediastinal Masses

Multidetector Computed Tomography Evaluation of Mediastinal Lesions with Histopathological Diagnosis

Characteristics associated with complete surgical resection of primary malignant mediastinal tumors

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