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Oncologic Disease

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Imaging in Pediatric Pulmonology

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Abstract

Primary thoracic neoplasms in children can arise within the lung, central airway, or chest wall. Malignant lesions are much more common than benign processes. However, metastatic tumors account for up to 80% of all lung tumors in children and more than 95% of the malignant ones. Due to the rarity and nonspecific presenting clinical symptoms of thoracic neoplasms in the pediatric population, a substantial delay in the diagnosis often occurs. Therefore, a high index of suspicion coupled with optimal imaging evaluation is of paramount importance in early and correct diagnosis. Early management can, in turn, result in decreased morbidity and mortality associated with lung, central airway, and chest wall neoplasms in pediatric patients. The prognosis of thoracic tumors in children varies depending on the malignant nature of the tumor, evidence of metastasis, and amenability to surgical excision. In this chapter, we discuss pediatric lung, central airway, and chest wall neoplasms including (1) clinical presentation; (2) practical approach to diagnosis; (3) histopathological characteristics; (4) radiological imaging findings; and (5) patient outcome. Malignant mediastinal masses are uncommon in children. Due to their rarity and often nonspecific clinical presentations, the correct diagnosis is unfortunately often initially missed or delayed in children. While these malignant mediastinal masses may be incidental findings in some children, they can also result in various symptoms depending on their size, location, mass effect upon adjacent mediastinal structures, and production of specific biochemical products. Imaging plays an important role for early and correct diagnosis, which in turn can improve patient care by guiding the next appropriate step in management. In this chapter, we discuss malignant mediastinal masses in pediatric patients with an emphasis on reviewing (1) clinical presentation; (2) practical imaging approaches to diagnosis; and (3) radiological imaging findings.

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Authors and Affiliations

  1. Department of Pediatrics, Harvard University/Massachusetts General Hospital for Children, Boston, MA, USA

    Benjamin A. Nelson MD

  2. Division of Thoracic Imaging, Department of Radiology and Medicine, Pulmonary Division, Children’s Hospital Boston, Harvard Medical School, Boston, MA, USA

    Edward Y. Lee MD, MPH

  3. Department of Pediatric Radiology, Children’s Hospital Boston, Harvard Medical School, Boston, MA, USA

    Shashi H. Ranganath MD

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  1. Benjamin A. Nelson MD
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  2. Edward Y. Lee MD, MPH
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  3. Shashi H. Ranganath MD
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Correspondence to Benjamin A. Nelson MD .

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  1. Children's Hospital Boston, Dept. Radiology, Harvard Medical School, Longwood Ave. 300, Boston, 02115, Massachusetts, USA

    Robert H. Cleveland

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Nelson, B.A., Lee, E.Y., Ranganath, S.H. (2012). Oncologic Disease. In: Cleveland, R. (eds) Imaging in Pediatric Pulmonology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-5872-3_13

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