Masses and mass like lesions Inflammatory changes Hematoma
Slide 14
Mediastinal masses
Slide 15
Imaging strategy Localized to mediastinum Localize within the
mediastinum
Slide 16
Localize to the mediastinum Unlike lung lesions, a mediastinal
mass will not contain air bronchograms. The margins with the lung
will be obtuse. Mediastinal lines (azygoesophageal recess, anterior
and posterior junction lines) will be disrupted. There can be
associated spinal, costal or sternal abnormalities.
Slide 17
LEFT: A lung mass abutts the mediastinal surface and creates
acute angles with the lung. RIGHT: A mediastinal mass will sit
under the surface of the mediastinum, creating obtuse angles with
the lung.
Slide 18
The lesion on the left was a pancoast tumor. The lesion on the
right was a thymoma, located within the anterior mediastinum.
Bronchogenic cyst A benign growth with respiratory origins.
Lymphadenopathy mediastinal An enlargement of the lymph nodes.
Pericardial cyst A benign growth that results from an "out-
pouching" of the pericardium (the hearts lining). Thyroid mass
mediastinal Usually a benign growth, such as a goiter. These types
of tumors can occasionally be cancerous. Tracheal tumors These
include tracheal neoplasms and non- neuplastic masses, such as
tracheobronchopathia osteochondroplastica (benign tumors). Vascular
abnormalities including aortic aneurysm and aortic dissection.
Middle mediastinum
Foregut duplication cysts occasionally contain milk of
calcium
Slide 58
4-year-old child with stridor
Slide 59
Duplication cyst
Slide 60
Slide 61
Hernia hernia
Slide 62
Slide 63
Esophageal varicosis
Slide 64
Mediastinal widdening >8 cm in the aortic knob depression of
the left main-stem bronchus deviation of the naso-gastric tube to
the right apical pleural haemoatoma (cap) disruption of the calcium
ring in the aortic knob (broken-halo) Aortic injury in blunt
trauma
Slide 65
Mediastinal hematoma
Slide 66
Some tips in differential diagnosis of mediastinal masses
