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Mediastinal Disease
Disease Mediastinal

Presentation

Understanding the pathology, clinical presentation, imaging and diagnosis of the major tumour types is instrumental in the safe and efficient work-up of a mediastinal mass. [ncbi.nlm.nih.gov]

Presentation of CaseA 65-year-old man was admitted to the hospital because of Hodgkin's disease of the anterior mediastinum and the radiographic finding of a pelvic mass.The patient had been well until about four months earlier, when pleuritic pain developed [nejm.org]

Operative checklists are included in procedural chapters, and procedures are presented as bulleted to-do lists wherever possible. [books.google.de]

Immune System

  • Mediastinal Lymphadenopathy

    […] disease can be separated into groups depending on whether the mediastinal disease is smooth or lobulated: smooth mediastinal lipomatosis mediastinal malignant infiltration mediastinal hemorrhage mediastinitis lobulated mediastinal lymphadenopathy thymic [radiopaedia.org]

    Of all cancers involving the same class of blood cell, 2% of cases are mediastinal large B cell lymphomas. [9] See also [ edit ] Mediastinal lymphadenopathy References [ edit ] ^ a b "Neurogenic Tumors of the Mediastinum". [en.wikipedia.org]

    lymphadenopathy due to lung, breast, renal cell, gastrointestinal, prostate. 25 Benign mediastinal lymphadenopathy Infectious Tuberculosis: Usually unilateral and asymmetric, may have calcification Fungal infections Histoplasmosis coccidioidomycosis [slideplayer.com]

Entire Body System

  • Fever

    Abstract Tuberculosis is a frequent cause of prolonged fever. Mediastinal lymph node enlargement is an uncommon feature of intrathoracic tuberculosis in adults. [ncbi.nlm.nih.gov]

    Night sweats Intermittent fever in about 35% of cases Infrequently, Pel-Ebstein fever (high fever for 1-2 wk followed by an afebrile period of 1-2 wk) A large mediastinal mass may produce chest pain, cough or shortness of breath Pruritus Nodal pain, [learningradiology.com]

    Some masses cause fever. Others cause difficulty swallowing. In children, mediastinal masses are more likely to cause cough or shortness of breath due to airway compression. [merckmanuals.com]

    Symptoms: Fever, sore back and neck, sepsis, tachypnea, emphysema. Treatment: Surgical drainage, hemodynamic support, tracheotomy and antibiotics, depending on the case. [topdoctors.es]

    Local pain, fever, tachicardia, leucocytosis are common. Ipsilateral hemidiaphragm is elevated on chest radiology. Pleural efusion, pulmonary infiltration or atelectasis can also be present. [slideplayer.com]

  • Lymphadenopathy

    […] sac Tracheal tumors Posterior mediastinal masses include: Extramedullary hematopoiesis: A rare mass formed from bone marrow Lymphadenopathy mediastinal: Disease of the lymph nodes Neuroenteric cyst mediastinal: Sacs that develop outside normal esophageal [utswmedicine.org]

    Lymphadenopathy mediastinal – An enlargement of the lymph nodes. Neuroenteric cyst mediastinal – A rare growth, which involves both neural and gastrointestinal elements. [my.clevelandclinic.org]

    So the patient on the left has pulmonary hypertension with moderately enlarged vessels while the patient on the right has sarcoidosis with widespread lymphadenopathy. [radiologyassistant.nl]

    Lymphadenopathy mediastinal - disease in the lymph nodes. Pericardial cysts which include growths that start in the lining of the heart. Tracheal tumors. Posterior mediastinal tumors include: Lymphadenopathy mediastinal - disease of the lymph nodes. [cedars-sinai.edu]

    A computed-tomography scan of her chest identified a mass in the anterior mediastinum without associated lymphadenopathy. [pediatrics.aappublications.org]

  • Weight Loss

    The most common symptoms in adults and children are chest pain and weight loss. Some masses cause fever. Others cause difficulty swallowing. [merckmanuals.com]

    Because of these radiologic findings and her weight loss, she was referred to the oncology service; a biopsy of the mediastinal mass was obtained and revealed thymic reactive hyperplasia. [pediatrics.aappublications.org]

    When symptoms occur, however, they often result from compression of the surrounding structures and may include: Cough Shortness of breath Chest pain Fever Chills Night sweats Coughing up blood Hoarseness Unexplained weight loss Lymphadenopathy (swollen [bmc.org]

    loss Palpable neck lymph nodes Diagnosis Hodgkin's lymphoma Locating masses within the mediastinum A lateral view may help determine the location of a mediastinal mass. [radiologymasterclass.co.uk]

    Depending on the location, nature, and size of the tumor or mass, symptoms may develop due to pressure on organs inside the chest and may include: Chest pain Coughing Fever, chills, night sweats Shortness of breath Weight loss Wheezing Diagnosis If we [utswmedicine.org]

  • Asymptomatic

    San Luigi Gonzaga, Regione Gonzole 10, I-10043, Orbassano (TO), Italy. [email protected] Abstract Mediastinal tumours are frequently asymptomatic and first noted on routine chest radiograph. [ncbi.nlm.nih.gov]

    Clinical Aspects Typical presentation One-third are asymptomatic incidental findings Two-thirds are symptomatic (causing airway or esophageal obstruction) and usually already manifest in infancy. [radiologykey.com]

    Symptomatology and clinical course Minor manifestation or asymptomatic course characterizes diaphragmatic relaxation. [intranet.tdmu.edu.ua]

    Most schwannomas are benign and asymptomatic, but signs of nerve compression and paralysis, Pancoast syndrome, and Horner's syndrome can occur. Germ cell tumors form from embryologically immature cells. [roswellpark.org]

    […] be a rebound phenomenon after lymphoma or germ cell tumor treatment or seen in MG 18 Mediastinal Lymphoma 10-20% of all mediastinal neoplasms in adults May be 1o in anterior or middle mediastinum or part of systemic malignancy 20-30% of patients are asymptomatic [slideplayer.com]

  • Chills

    When symptoms occur, however, they often result from compression of the surrounding structures and may include: Cough Shortness of breath Chest pain Fever Chills Night sweats Coughing up blood Hoarseness Unexplained weight loss Lymphadenopathy (swollen [bmc.org]

    Depending on the location, nature, and size of the tumor or mass, symptoms may develop due to pressure on organs inside the chest and may include: Chest pain Coughing Fever, chills, night sweats Shortness of breath Weight loss Wheezing Diagnosis If we [utswmedicine.org]

    General symptoms, which are sometimes mistakenly attributed to a cold or flu, include shortness of breath, cough, fever, chills, night sweats, unexplained weight loss, swollen lymph nodes and hoarseness. [roswellpark.org]

    Night sweats, chills or fever. Wheezing or a high-pitched breathing noise. Unexplained weight loss and anemia. Swollen or tender lymph nodes. Causes and Risk Factors Mediastinal tumors are rare. [cedars-sinai.edu]

    Other symptoms of mediastinal tumors may include: Chest pain Fever or chills Hoarseness Night sweats Shortness of breath Wheezing Swollen lymph nodes Unexplained weight loss Because these symptoms may be associated with other medical problems, it is important [nyp.org]

Respiratoric

  • Cough

    In children, mediastinal masses are more likely to cause cough or shortness of breath due to airway compression. [merckmanuals.com]

    When symptoms occur, however, they often result from compression of the surrounding structures and may include: Cough Shortness of breath Chest pain Fever Chills Night sweats Coughing up blood Hoarseness Unexplained weight loss Lymphadenopathy (swollen [bmc.org]

    K. was a 15-year-old girl evaluated for cough and dyspnea on exertion. A chest radiograph was obtained, and it revealed a widened superior mediastinum. [pediatrics.aappublications.org]

    When symptoms are present they are often a result of the compression of surrounding structures, such as the spinal cord, heart or the pericardium (the heart's lining), and may include: Cough Shortness of breath Chest pain Fever Chills Night sweats Coughing [my.clevelandclinic.org]

    Symptoms can include: cough shortness of breath chest pain fever/chills night sweats coughing up blood unexplained weight loss swollen lymph nodes respiratory blockage hoarseness If you have symptoms of a mediastinal tumor, your doctor will order additional [healthline.com]

  • Hoarseness

    When symptoms occur, however, they often result from compression of the surrounding structures and may include: Cough Shortness of breath Chest pain Fever Chills Night sweats Coughing up blood Hoarseness Unexplained weight loss Lymphadenopathy (swollen [bmc.org]

    General symptoms, which are sometimes mistakenly attributed to a cold or flu, include shortness of breath, cough, fever, chills, night sweats, unexplained weight loss, swollen lymph nodes and hoarseness. [roswellpark.org]

    Depending on the size and location of the tumor, symptoms may develop due to pressure on the spinal cord, heart or heart lining (pericardium) and may include: Coughing with or without blood, shortness of breath and hoarseness. [cedars-sinai.edu]

    Other symptoms of mediastinal tumors may include: Chest pain Fever or chills Hoarseness Night sweats Shortness of breath Wheezing Swollen lymph nodes Unexplained weight loss Because these symptoms may be associated with other medical problems, it is important [nyp.org]

    […] are present they are often a result of the compression of surrounding structures, such as the spinal cord, heart or the pericardium (the heart's lining), and may include: Cough Shortness of breath Chest pain Fever Chills Night sweats Coughing up blood Hoarseness [my.clevelandclinic.org]

  • Dyspnea

    A 77-year-old woman was referred to our center for the workup of progressive exertional dyspnea. The patient had a medical history of systemic hypertension and diabetes mellitus. [circ.ahajournals.org]

    K. was a 15-year-old girl evaluated for cough and dyspnea on exertion. A chest radiograph was obtained, and it revealed a widened superior mediastinum. [pediatrics.aappublications.org]

    Patients are usually asymptomatic but can present with myasthenia gravis-related symptoms, substernal pain, dyspnea, or cough. [en.wikipedia.org]

    Tracheostomy Bronchoscopic procedures Respiratory tract infections Dental infections or procedures Acute mediastinitis Pneumoperitoneum Esophageal perforation 45 Substernal chest pain is the most frequent symptom Crepitation; air dissecting under the skin Dyspnea [slideplayer.com]

    It causes the diminishing of vital capacity of the lungs and development of dyspnea. [intranet.tdmu.edu.ua]

  • Hemoptysis

    For example, a mass compressing the airway can lead to lung infection or hemoptysis (coughing up blood), while a mass compressing the esophagus can cause dysphagia (difficulty swallowing). [nyp.org]

    The patient was in New York Heart Association functional class III and had no history of syncope or hemoptysis. Physical examination found an overweight woman (body mass index, 36 kg/m 2 ) with no signs of right heart failure. [circ.ahajournals.org]

    […] period of 1-2 wk) A large mediastinal mass may produce chest pain, cough or shortness of breath Pruritus Nodal pain, especially if preceded by drinking alcohol may occur in less than 10% of patients but is characteristic of Hodgkin lymphoma Rarely, hemoptysis [learningradiology.com]

    The symptoms most commonly associated with mediastinal tumors are: chest pain cough shortness of breath A person who has a mediastinal tumor may be hoarse, cough up blood ( hemoptysis ), or have: fatigue difficulty swallowing (dysphagia) night sweats [encyclopedia.com]

    The compression of major bronchi and trachea results in occurrence of dyspnea, paroxysmal cough and hemoptysis. The infection of the tumour frequently leads to fever and increase of intoxication. [intranet.tdmu.edu.ua]

Gastrointestinal

  • Dysphagia

    · Belsey (Mark IV) fundoplication: This operation involves a 270° wrap in an attempt to reduce the incidence of gas bloating and postoperative dysphagia. [intranet.tdmu.edu.ua]

    For example, a mass compressing the airway can lead to lung infection or hemoptysis (coughing up blood), while a mass compressing the esophagus can cause dysphagia (difficulty swallowing). [nyp.org]

    Bronchoscopic procedures Respiratory tract infections Dental infections or procedures Acute mediastinitis Pneumoperitoneum Esophageal perforation 45 Substernal chest pain is the most frequent symptom Crepitation; air dissecting under the skin Dyspnea Dysphagia [slideplayer.com]

    The symptoms most commonly associated with mediastinal tumors are: chest pain cough shortness of breath A person who has a mediastinal tumor may be hoarse, cough up blood ( hemoptysis ), or have: fatigue difficulty swallowing (dysphagia) night sweats [encyclopedia.com]

    The second patient is a 23-year old female without significant medical history who was transferred to our institution with increasing shortness of breath, dysphagia, cervical lymphadenopathy and a mediastinal mass identified on chest CT (Figure 1 C). [thyroidresearchjournal.biomedcentral.com]

  • Vomiting

    Treatment involving chemotherapy and radiation can have serious side effects, such as: changes in appetite bleeding problems anemia constipation diarrhea fatigue hair loss infection nausea/vomiting pain swelling Radiation may also cause changes in the [healthline.com]

    Case presentations Patients A 12 year-old African American male with a one year history of GD refractory to medical management presented with a persistent tachycardia, fever, abdominal pain, vomiting, weakness and muscle aches after discontinuing methimazole [thyroidresearchjournal.biomedcentral.com]

    As the pressure rises in mediastinum, air moves to cervical, subcutaneous and retroperitoneal soft tissue places. 44 Etiology of pneumomediastinum Spontaneous Acute asthma attack Scuba diving Mechanic ventilation Vomiting Trauma Surgery Tracheostomy Bronchoscopic [slideplayer.com]

    Meanwhile heartburn, belching, nausea, vomiting and meteorism also observed. A phrenocardiac Uden-Ramcheld's syndrome represents cardiopulmonary signs. [intranet.tdmu.edu.ua]

  • Hiccup

    […] breastbone) · Increased by bending, stooping, lying down, or eating · More likely or worse at night · Relieved by antacids · Nausea after eating Less common symptoms are: · Bringing food back up (regurgitation) · Cough or wheezing · Difficulty swallowing · Hiccups [intranet.tdmu.edu.ua]

Cardiovascular

  • Chest Pain

    The most common symptoms in adults and children are chest pain and weight loss. Some masses cause fever. Others cause difficulty swallowing. [merckmanuals.com]

    Others cough or experience chest pain. THYROID TUMORS. Most mediastinal thyroid tumors grow out of goiters and occur in women between the ages of 50 and 60. About 75% of these tumors extend to the windpipe (trachea). The rest extend behind it. [encyclopedia.com]

    When symptoms occur, however, they often result from compression of the surrounding structures and may include: Cough Shortness of breath Chest pain Fever Chills Night sweats Coughing up blood Hoarseness Unexplained weight loss Lymphadenopathy (swollen [bmc.org]

    pain radiating to the neck and back Diagnosis Chronic thoracic aortic aneurysm – treated with surgical repair of the aortic root « Previous Top Next » Last reviewed : September 2016 [radiologymasterclass.co.uk]

    Depending on the location, nature, and size of the tumor or mass, symptoms may develop due to pressure on organs inside the chest and may include: Chest pain Coughing Fever, chills, night sweats Shortness of breath Weight loss Wheezing Diagnosis If we [utswmedicine.org]

  • Heart Disease

    The local symptomatology of the disease depends on location of the process and involvement of esophagus, trachea, heart, n. vagus, n. рhrеnісus, n. recurrens, tr. sуmраtісus. [intranet.tdmu.edu.ua]

Skin

  • Sweating

    […] lymphocyte predominant Hodgkin disease (NLPHD) Distinct entity -- unique clinical features, different treatment Clinical Findings Most patients with disease above diaphragm are asymptomatic “B” symptoms are present in 40% Unexplained weight loss Fever Night sweats [learningradiology.com]

    When symptoms occur, however, they often result from compression of the surrounding structures and may include: Cough Shortness of breath Chest pain Fever Chills Night sweats Coughing up blood Hoarseness Unexplained weight loss Lymphadenopathy (swollen [bmc.org]

    […] hide findings Click image to align with top of page Mediastinal mass Wide upper mediastinum ( arrowheads ) Poorly defined aortic knuckle – indicating adjacent disease Wide right paratracheal stripe ( asterisk ) Normal lungs Clinical information Night sweats [radiologymasterclass.co.uk]

    Depending on the location, nature, and size of the tumor or mass, symptoms may develop due to pressure on organs inside the chest and may include: Chest pain Coughing Fever, chills, night sweats Shortness of breath Weight loss Wheezing Diagnosis If we [utswmedicine.org]

    Hyperhidrosis Hyperhidrosis is a condition that causes excessive sweating, usually in the hands, underarms and face, but without the usual triggers such as exercise or stress. In some cases, surgery can treat this condition. [dartmouth-hitchcock.org]

  • Blister

    […] radiation can have serious side effects, such as: changes in appetite bleeding problems anemia constipation diarrhea fatigue hair loss infection nausea/vomiting pain swelling Radiation may also cause changes in the skin, like: dryness itching peeling blistering [healthline.com]

Workup

A 77-year-old woman was referred to our center for the workup of progressive exertional dyspnea. The patient had a medical history of systemic hypertension and diabetes mellitus. [circ.ahajournals.org]

Other Pathologies

  • Lymph Node Hyperplasia

    Palabras clave Giant Lymph Node hyperplasia; Mediastinum; Tomography scanners, X-ray computed [revistamedicadechile.cl]

Treatment

Current guidelines recommend empirical treatment after material for histology and culture has been obtained1. [erj.ersjournals.com]

Hoppe RT: Radiation therapy in the treatment of Hodgkin’s disease. Semin Oncol 1980;7:144–154. [karger.com]

This ensures that each patient gets a personal treatment plan, which helps us achieve better outcomes. [surgery.usc.edu]

The specific treatment will depend on the type of tissue, its location, size, and the overall health of the patient. [utswmedicine.org]

Multidisciplinary contributions on medical treatment, radiation oncology, and surgery and anesthesia are included. Highlights include new material on minimally invasive procedures and thoroughly updated diagnostic and treatment information. [books.google.de]

Prognosis

A mediastinal lymph node mass, located in the center of the chest, that is larger than 10 centimeters (cm) is associated with a poorer prognosis. Small mediastinal masses are not associated with a poorer prognosis. [cancer.net]

Prognostically, mediastinal node enlargement worsens prognosis but only minimally. [learningradiology.com]

The prognosis for these tumors even after resection is usually judged to be poor. [hon.ch]

Therapy in stage I tumors consists of surgical resection with good prognosis. Stage II-III requires maximal resection possible followed by radiation. [en.wikipedia.org]

Etiology

This division is particularly useful for characterizing mediastinal masses because specific etiologic factors often have a predilection for a particular compartment. [clinicalgate.com]

Etiology, pathophysiology, pathogenesis Bronchogenic cysts arise from the ventral foregut, enteric cysts from the dorsal foregut Bronchogenic cysts contain respiratory epithelium, smooth muscle, and cartilage; enteric cysts contain squamous and gastrointestinal [radiologykey.com]

Compression of the airway, pulmonary arteries or veins may occur Etiology: Tuberculosis Histoplasmosis or other fungi Silicosis Drugs (Methisergide) Autoimmune disorders Familial multifocal fibrosclerosis 61 Symptoms are caused by the compression of vital [slideplayer.com]

Etiology and pathogenesis The cause of occurrence of congenital hernia is the disturbance of embryogenesis with transformation in anomaly of diaphragm. [intranet.tdmu.edu.ua]

There was no history of hereditary etiology of vascular disease such as von Hippel-Lindau disease. The patient had no remarkable family history. A physical examination revealed a healthy looking woman with no obvious signs. [jtd.amegroups.com]

Epidemiology

Chest 1997; 112: 511 Neurogenic Tumors Definition Epidemiology Account for 10–20% of mediastinal masses 90% occur in the posterior mediastinum Usually benign (80%). [radiologykey.com]

It is epidemiology, clinically and biologically distinct from the other subtypes of DLBCL. [atlasgeneticsoncology.org]

Thoracic Surgeons IASLC International Association for the Study of Lung Cancer ITMIG International Thymic Malignancies Interest Group JART Japanese Association for Research on the Thymus NCCN National Comprehensive Cancer Network SEER Surveillance, Epidemiology [haigan.gr.jp]

Epidemiology Superior vena cava syndrome is chiefly associated with malignancy. Currently, more than 90% of patients with superior vena cava syndrome have an associated malignancy as the cause. [intranet.tdmu.edu.ua]

Pathophysiology

Etiology, pathophysiology, pathogenesis Bronchogenic cysts arise from the ventral foregut, enteric cysts from the dorsal foregut Bronchogenic cysts contain respiratory epithelium, smooth muscle, and cartilage; enteric cysts contain squamous and gastrointestinal [radiologykey.com]

Pathophysiology Extrinsic compression of the superior vena cava is possible because it has a thin wall coupled with a low intravascular pressure. Because the superior vena cava is surrounded by rigid structures, it is relatively easy to compress. [intranet.tdmu.edu.ua]

Prevention

Tuberculosis: clinical diagnosis and management of tuberculosis, and measures for its prevention and control. 2006. © 2011 ERS [erj.ersjournals.com]

Considering the diagnosis of Graves disease for a child with an anterior mediastinal mass and without the typical physical findings of autoimmune hyperthyroidism (goiter, exophthalmos) may prevent unnecessary diagnostic studies and their associated financial [pediatrics.aappublications.org]

RGS with radiolabeled somatostatin analogues in this case appears to be a useful method for real time tumour localization, verification of complete excision to prevent recurrence. This means that the surgery is less extent and with lower morbidity. [omicsonline.org]

These include: Pleural effusion: excess fluid that accumulates in the pleural space and can prevent the lungs from expanding normally. [lung.templehealth.org]

Pneumothorax (collapsed lung) : When a patient's lung collapses more than once, video-assisted thoracoscopic surgery is performed to prevent it from recurring. [uchospitals.edu]

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