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Mediastinal tumours
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Mediastinal cysts comprise 12%–20% of mediastinal masses and are found in the middle compartment of the mediastinum (140–142). Despite a similar incidence, children are more often symptomatic at presentation because of compression on the surrounding structures (143). The most common type of mediastinal cyst is the foregut cyst, which is derived as an embryonic abnormality, with enterogenous cysts (50%–70%) and bronchogenic cysts (7%–15%) being the most common subtypes (6).
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
The anterior mediastinum is bordered anteriorly by the sternum and posteriorly by the great vessels. It contains the thymus, lymph nodes, fat, and vessels. Disorders of the anterior mediastinum are generally thymic, thyroid (substernal goitre), teratoma (and other germ cell tumours), and lymphomas (Hodgkin disease, non-Hodgkin lymphoma).
Hiccup
Published in Wesley C. Finegan, Angela McGurk, Wilma O’Donnell, Jan Pederson, Elizabeth Rogerson, Care of the Cancer Patient, 2018
Wesley C. Finegan, Angela McGurk, Wilma O’Donnell, Jan Pederson, Elizabeth Rogerson
Brain tumours, especially brainstem.Diaphragmatic tumour invasion.Mediastinal tumour.Meningeal infiltration by tumour deposits.
Mycotic aneurysm of the ascending aorta due to Escherichia coli: a case report
Published in Acta Cardiologica, 2022
Ines Zekhnini, Danae Halleux, Rodolphe Durieux, Jean Olivier Defraigne, Marc Radermecker, Vincent Tchana-Sato
She underwent urgent surgery. A median sternotomy was performed, and extracorporeal circulation (ECC) was established between the right atrium and the right axillary artery. The anterior mediastinum was massively infiltrated by an inflammatory tissue with pus. The affected AA was completely resected under moderate hypothermic circulatory arrest (25 °C). The surrounding inflammatory tissues were extensively debrided. The AV was explored, and there was no vegetation. The AV leaflets were thickened, with the presence of small strands on the left cusp (Lambl’s excrescences), which were resected. In situ reconstruction of the AA was carried out with a cryopreserved homograft from the supracoronary level up to the origin of the innominate artery (Figure 2). The patient was successfully weaned from the ECC with catecholamine support. She was extubated on postoperative day (POD) 6 because of delayed awakening. She stayed 12 days in the intensive care unit (ICU).
Mediastinal endometriosis with schwannoma: a case report
Published in Journal of Obstetrics and Gynaecology, 2022
Weihong Zhao, Yaqin Li, Honglei Zhang, Yatao Liu
This case illustrates the importance of history-taking when a woman complains of recurrent chest pain, especially in proximity to her menstrual periods. Only this one symptom raises suspicion of endometriosis. Most previous studies show that pneumothorax is the most common symptom (Channabasavaiah and Joseph 2010; Chatra 2012). However, Nezhat (Nezhat et al. 2014) reported that 80% cases of thoracic endometriosis complained of catamenial chest pain, with 40% having only that one symptom, and 24% with pneumothorax. Therefore, using the lower threshold of symptoms to diagnose thoracic endometriosis does not decrease the specificity of diagnosis. However, mediastinal masses should be subclassified into abscesses, haematomas, or tumours. Patients with abscesses show chest pain and radiation to the neck, high fever, chills, mediastinal widening, abscess, and gas-fluid levels on CT. Patients with haematomas often have a history of trauma. CT often shows a mediastinal soft tissue mass compressing the trachea or oesophagus. The nature of mediastinal tumours is location-related. Thymoma and teratoma are common in the anterior mediastinum, lymphoma and lymph cyst in the middle, and neurogenic tumours in the posterior mediastinum. The final diagnosis depends on histopathological examination. The imaging characteristics of endometriosis may be similar to cysts; CT is often of little use.
Pediatric Bronchogenic Cysts: A Case Series of Six Patients Highlighting Diagnosis and Management
Published in Journal of Investigative Surgery, 2020
Jason E. Cohn, Kimberly Rethy, Rajeev Prasad, Judy Mae Pascasio, Katie Annunzio, Seth Zwillenberg
The differential diagnosis for bronchogenic cysts depends on their location in the body. A cystic neck mass can be a thyroglossal duct cyst, dermoid cyst, abscess, hemangioma, ranula, congenital midline cervical cleft, suspicious lymphoid hyperplasia, or a manifestation of sarcoidosis [11, 12] The working diagnosis for a cystic midline neck mass is abscess, thyroglossal duct cyst and bronchogenic cyst. A chest wall cyst differential should include epidermoid cyst, teratoma, lymphangioma, dermoid cyst, pilomatrixoma, in addition to bronchogenic cyst [13]. The working diagnosis for a cystic chest wall mass is dermoid cyst, teratoma, and bronchogenic cyst. A mediastinal cyst can be tuberculosis, foregut cyst, pericardial cyst, congenital cystic adenoid malformation, pulmonary sequestration, large B cell lymphoma, and enterogenic cyst [14]. The working diagnosis for a mediastinal cyst is foregut duplication cyst (including the bronchogenic and enterogenic variety) and pericardial cyst.