Sandbox:Trusha

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]

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Micropathology: Squamous cell carcinoma of the lung. H&E stain, By Nephron Wikimedia Commons

Gross pathology: Bronchial squamous lung cell cancer By John Hayman [Public domain], (Image source: Wikimedia Commons)

1. Superior vena cava obstruction
2. Partial anomalous pulmonary venous connection
3. Esophageal achalasia
4. Esophageal cancer
5. Esophageal rupture
6. Hiatus hernia
7. Hilar lymphadenopathy
8. Pneumomediastinum
9. Sarcoidosis
10. Lymphoma
11. Neurilemmoma
12. Non-Hodgkin lymphoma
13. Teratoma
14. Thymoma

1. Thyroid cancer
2. Goitre
3. Mediastinal germ cell tumor,
4. Mediastinal tumor,
5. Mediastinitis

1. Churg-Strauss syndrome
2. Bronchogenic cyst,
3. Dermoid cyst
4. Anthrax:
5. Tularemia

CT scan shows cystic mass which was located on the posterior to the lower esophagus later diagnosed as thoracic duct lymphangioma. Source:Case courtesy of Jin San Bok et al, Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital

CT scan showing a soft tissue density lesion within the left posterior mediastinum, in a paravertebral location. The lesion is closely related to the left neural exit foramen, but there is no definite extension into the spinal canal. The lesion does extend into the intercostal space. Case courtesy of Dr Paul Leong (Picture courtesy:Radiopedia)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]; Associate Editor(s)-in-Chief: Trusha Tank, M.D.[4], Amr Marawan, M.D. [5]

Synonyms and keywords: Mediastinal enlargement; mass in the mediastinum

Overview

The mediastinum is a non-delineated group of structures in the thorax (chest), surrounded by loose connective tissue. Since it is the central compartment of the thoracic cavity, and it contains a lot of important structures, it is the site of involvement of various tumors.

Initial Evaluation

Mediastinal Mass

Workups ❑ CT chest with contrast ❑ Serum beta-HCG, AFP, if appropriate ❑ CBC, platelets ❑ PET-CT scan (optional) ❑ Pulmonary function tests if clinically indicated ❑ MRI chest if clinically indicated

Thymic Tumor Likely

Thymic Tumor Unlikely

Consider surgery

Disease-specific management