Chest diseases
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1. Different types of mediastinal masses have characteristic locations and relationships to surrounding structures on imaging. 2. Anterior mediastinal masses may efface the heart border or margin of the ascending aorta. Middle mediastinal masses may splay the carina. Posterior mediastinal masses displace the paravertebral lines laterally. 3. Thymic cysts can occur within the thymus gland or following radiation therapy. On imaging they appear as large, inhomogeneous solid masses in the antero-left mediastinum without calcium or fat.
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The document discusses radiographic imaging techniques for evaluating mediastinal masses. It begins by explaining that computed tomography (CT) is the most important tool for characterizing mediastinal abnormalities based on tissue attenuation. Magnetic resonance imaging (MRI) also allows excellent evaluation of mediastinal tumors due to its soft tissue contrast. The document then describes several radiographic signs and landmarks that can help locate a mediastinal mass to a specific compartment. These include the hilum overlay sign, effects on nearby structures, and relationships to lines like the paratracheal stripe or azygoesophageal recess. Thymoma is discussed as a common anterior mediastinal tumor that appears on CT as a homogeneous soft tissue mass, sometimes with calc
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This chapter discusses mediastinal masses. It describes the different compartments of the mediastinum and states that 60% of mediastinal masses arise in the anterior compartment. It lists the most common causes of masses in each compartment, known as the "4 Ts" in the anterior compartment: thymoma, thyroid masses, teratomas, and lymphoma. It provides details on imaging features of these masses and others, such as cysts, abscesses, and vascular abnormalities. CT is useful for further characterizing masses and determining if they involve surrounding structures.
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Chest diseases
- 5. LEFT: A lung mass abuts 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.
- 6. *Before you want to biopsy an anterior mediastinal mass, do not forget that some of these lesions can be vascular in origin
- 7. Anterior mediastinal mass Lies adjacent to the heart. It may efface a heart border or the margin of the ascending aorta. Middle mediastinal mass May splay the carina or efface a normal hilar shadow. It will not efface heart border nor widen a paraspinal line. Posterior mediastinal mass Will diplace either or both of the paravertebral stripes laterally. It may also widen the space between the ribs and destroy a vertebra or rib.
- 13. Proceed with CT
- 26. Thymic cysts: these may be simple in nature ▶ they can occur within a normal gland, a thymoma, or following thymic irradiation for Hodgkin’s disease
- 29. Film findings: • large, inhomogeneous, • solid, antero-left mediastinal mass. • No calcium. • No fat.
- 40. ** haemorrhage or infection can lead to a rapid size increase ** it can occasionally rupture into the mediastinum or lung (mimicking the appearance of a malignant lesion)
- 73. Lesion (arrows) is visible behind the heart on radiograph. Esophageal narrowing (arrows) is caused by duplication.
- 76. + Vascular
- 82. PA chest radiograph demonstrates a subcarinal abnormality with increased opacity (*), splaying of the carina, and abnormal convexity of the upper and middle thirds of the azygoesophageal line
- 83. PA CXR shows a mass obliterating the posterior junction line. Note that the mass extends above the level of the clavicle and has a well-demarcated outline due to the interface with adjacent lung
- 125. • LUNG MALIGNANCY • SOLITARY PULMONARY NODULE (SPN) Primary Lung Ca (Bronchogenic) Lung metastases
- 147. Staging For NSCLC and SCLC TNM 8th edition Size of a solid lesion is defined as maximum diameter in any of the three orthogonal planes in lung window. In subsolid lesions T-classification is defined by the diameter of the solid component and not the diameter of the complete groundglass lesion.
- 148. Incidence: 2% of bronchogenic carcinoma METABOLIC Cushing syndrome (ACTH) Inappropriate antidiuresis (SIADH) Carcinoid syndrome (serotonin, other vasoactive substances) Hypercalcemia (PTH, bone metastases) Hypoglycaemia (Insulin-like factor) MUSCULOSKELETAL Neuromyopathies HPOA (Hypertrophic osteoarthropathy) CNS Eaton–Lambert syndrome (myasthenialike syndrome) Subacute cerebellar degeneration Limbic encephalopathy OTHERS Acanthosis nigricans Thrombophlebitis Anaemia
- 153. Pulmonary nodules are frequently encountered incidentally on chest CT. The role of the radiologist is to separate between benign and possibly malignant lesions, and advise on follow-up imaging or additional invasive imaging techniques.
- 170. ATYPICAL PNEUMONIA
- 195. Opportunistics