23 Anterior Mediastinal Lesions

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig C 23-1 Substernal thyroid. (A) Marked widening of the superior mediastinum to both sides (arrows) and severe deviation of the trachea to the right. (B) Iodine-131 scan shows increased uptake of the radionuclide in the area of the mass seen on the radiograph.42

• Fig C 23-2 Thymoma. (A) Frontal view shows a large bilateral lobulated mass (arrows) extending to both sides of the mediastinum. (B) Lateral view shows filling of the anterior precardiac space by a mass and posterior displacement of the left side of the heart.

• Fig C 23-3 Thymoma with myasthenia gravis. (A) Frontal and (B) lateral views of the chest demonstrate a large mass in the anterior mediastinum (arrows).

• Fig C 23-4 Teratodermoid tumor. Large lobulated mass confluent with the right border of the heart.

• Fig C 23-5 Lymphoma. Diffuse widening of the upper portion of the mediastinum due to lymphadenopathy. There is an ill-defined lymphomatous parenchymal infiltrate at the left base. The metallic clip overlying the region of the spleen (small arrow) and the small amount of free intraperitoneal gas seen under the right hemidiaphragm (large arrows) are evidence of a recent exploratory laparotomy and splenectomy for staging of the lymphoma.

• Fig C 23-6 Mediastinal lipomatosis. Generalized widening of the upper mediastinum.43

• Fig C 23-7 Aneurysm of the thoracic aorta. (A) Frontal and (B) lateral views of the chest demonstrate marked dilatation of both the ascending and descending portions of the thoracic aorta (arrows, B), producing anterior and posterior mediastinal masses, respectively.

• Fig C 23-8 Pericardial cyst. (A) Frontal and (B) oblique views demonstrate a smooth mass (arrows) in the right cardiophrenic angle.