China
Africa
Explore chapters and articles related to this topic
Mediastinal masses
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Brent R. Weil, Robert C. Shamberger
Mass lesions of the mediastinum have multiple origins and may appear at any age throughout infancy, childhood, and adolescence. The mass may be cystic or solid, and of either congenital or neoplastic origin. The symptoms produced by a mediastinal mass are almost as diverse as the underlying pathology of these lesions, but most symptoms are due to the “mass effect” of the lesion which may compress the airway, vasculature, esophagus, or lung. Occasionally, they present with pain resulting from inflammation produced by infection or perforation of a cyst. Invasion of the chest wall by a malignant tumor will also produce pain. Many mediastinal lesions, in fact, are found as a radiographic abnormality on a study obtained for symptoms unrelated to the mass. Respiratory symptoms of expiratory stridor, cough, dyspnea, or tachypnea require urgent investigation. Cystic or solid lesions located at the carina may produce major airway obstruction. Lesions at this site are often “hidden” in the normal mediastinal shadow and may not be apparent on the anterior–posterior or lateral chest radiographs. Orthopnea and venous engorgement from superior vena caval syndrome occur with extensive involvement of the anterior mediastinum and are harbingers for respiratory obstruction upon induction of a general anesthetic. Less frequently, dysphagia from pressure on the esophagus is the presenting symptom. Neurologic symptoms from spinal cord compression or Horner's syndrome may occur with neurogenic tumors arising in the posterior mediastinum.
Mediastinal tumours
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Thymomas are the most common anterior mediastinal mass, with an incidence of 0.15 cases per 100,000, accounting for 20% of anterior mediastinal neoplasms in adults but less than 1% of adult malignancies (26–30). They usually occur in patients between the ages of 45 and 60, being rare below the age of 20 and affecting men and women equally (30,31).
Acute lymphoblastic leukemia (ALL)
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
The chest radiograph shows a mediastinal mass. The differential diagnosis includes solid lesions (thymus, thymoma, lymphoma, teratoma), cystic lesions (thymic cyst, lymphatic malformation), fatty lesions (lipoma), vascular lesions (double aortic arch), nonvascular lesions (bronchogenic cyst), and lymphadenopathy (neoplasms primary, metastatic disease, infection).
Heart of lymphoma: a case report
Published in Acta Cardiologica, 2023
Annemie Jacobs, Thomas Gevaert, Wim Volders, Dieter De Cleen, Katrien Van Kolen, Frank Cools, Steven Hellemans
During his hospitalisation, he relapsed in a new febrile episode, possibly due to a recurring pneumonia. Given his medical history, the actual presence of numerous comorbidities and the aggressive behaviour of his newly diagnosed tumour, tissue biopsy of the mediastinal mass could not be performed, after multidisciplinary consultation between his treating physicians and the consulting specialists at the tertiary referral centre. A choice of comfort care was preferred by the patient and his family members. The patient died 4 weeks after admission. A histological examination post-mortem confirmed the suspicion of mediastinal diffuse large B-cell lymphoma with secondary involvement of the right ventricular free wall and the pericardium on the right side (Figure 4–5). Immunostaining showed that the neoplastic lymphoid cells were diffusely positive for CD20 (Figure 5B).
Mediastinal endometriosis with schwannoma: a case report
Published in Journal of Obstetrics and Gynaecology, 2022
Weihong Zhao, Yaqin Li, Honglei Zhang, Yatao Liu
After her admission, the physical examination and laboratory tests showed no abnormal findings. A chest computed tomography (CT) scan showed a lobulated tumour (80 × 50 × 40 mm) in the upper left chest close to the spine, with a homogenous inner component (see Figure 1(A,B)). The patient underwent a surgical resection of the upper left mediastinal mass on May 27 2007. From the left posterolateral incision to probe into the chest between the fifth rib, there was a 80 × 50 × 40 mm of smooth surface, leaf morphological cyst in the upper left mediastinum adjacent to the fourth thoracic vertebra. We first used a syringe to extract 15 mL of stable blood from the cyst, and then gradually disassociated the surrounding cyst and adhered to the mediastinal pleura, with the base located in the ribs and near the spine. After ligation, resection was performed, hemostasis was performed, drainage tubes were placed, and the chest was closed layer by layer. There were no postoperative complications and the patient was discharged eight days postoperatively. The postoperative pathological findings showed a schwannoma with endometriosis. The focus showed endometrial glands, haemorrhagic, necrotic, and cystic degeneration (Figure 1(C)). Immunohistochemical study revealed that the tumour stromal cells were positive for NSE, SMA, CD34, and S-100 protein. Masson dye staining showed fibre distribution.
A lymphoproliferative pericardial mass
Published in Baylor University Medical Center Proceedings, 2020
Barbara Mantilla, Kenneth Nugent, Ximena Solis, Pablo Paz, Haneen Mallah, John Makram, Safaa Labib, Andres Yepes-Hurtado
A 43-year-old man with known asthma and hypertension was found to have an asymptomatic incidental mediastinal mass. He denied constitutional symptoms, chest pain, and dyspnea and reported only a mild nocturnal cough. Chest computed tomography (CT), magnetic resonance imaging, and magnetic resonance angiography showed a right posterior pericardial mass (6.9 × 6.4 × 5.1 cm) compressing the right atrium and partially encasing the right lower lobe bronchi and pulmonary vasculature with associated subcarinal and paratracheal lymphadenopathy. It did not show evidence of arteriovenous malformation (Figure 1). Positron emission tomography (PET) showed a mild increase in fluorodeoxyglucose uptake in the right mediastinal mass abutting the right atrium. An endobronchial ultrasound bronchoscopy noted extrinsic compression at the right upper and right middle lobe from the mass. Pathology results were negative for malignancy.