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Imaging of Mediastinal Tumors

  • Chapter
Imaging in Oncology

Part of the book series: Cancer Treatment and Research ((CTAR,volume 143))

The mediastinum comprises the region extending from the thoracic inlet to the diaphragm in the central thorax, interposed between the two pleural cavities [1]. Tradi - tionally, the mediastinum is separated into three compartments (anterior, middle and posterior) as a classification scheme, since various tumor types are more common in certain locations. These compartments are not actual anatomic locations divided by fascial planes, but are hypothetical regions radiographically. No universal approach to subdividing the mediastinum is utilized, but the scheme developed by Fraser, et al. [2], which is based on the lateral radiograph, is applied in this review. The anterior mediastinum is anterior to the pericardium and brachiocephalic vessels, and includes the thymus gland, lymph nodes and fat. The posterior mediastinum is posterior to the heart and trachea and extends from the posterior pericardial reflection to the posterior border of the vertebral bodies. It includes the autonomic ganglia, descending thoracic aorta, azygous vein, esophagus, lymph nodes, thoracic duct and fat. The remaining middle mediastinum is the space between the aforementioned spaces and includes the heart, intrapericardial great vessels, pericardium, trachea, and lymph nodes.

The risk of malignancy is primarily related to which compartment the tumor occupies, as masses in the anterior compartment are statistically favored to be malignant [3]. Age and symptomatology are additional variables to be considered. Most mediastinal tumors in infants and children are neurogenic tumors; adults between the ages of 20 and 40 years are more likely to have a germ cell tumor or lymphoma. These populations of patients are more at risk of having a malignant mediastinal mass. Almost 75 percent of patients displaying symptoms have malignant medastinal tumors [3]. The most common symptoms include chest pain, cough, dyspnea, fever, chills and rarely, superior vena cava syndrome.

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    Scott Moore M.D., Hetal Dave-Verma M.D. & Ajay Singh M.D.

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Moore, S., Dave-Verma, H., Singh, A. (2008). Imaging of Mediastinal Tumors. In: Blake, M.A., Kalra, M.K. (eds) Imaging in Oncology. Cancer Treatment and Research, vol 143. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-75587-8_6

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