Mediastinal tumors
Mediastinal tumor | |
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Micrograph of the primitive neuroepithelium of an immature teratoma of the mediastinum. H&E stain. | |
Specialty | Oncology |
A mediastinal tumor is a
The mediastinum has three main parts: the anterior mediastinum (front), the middle mediastinum, and the posterior mediastinum (back). Masses in the anterior portion of the mediastinum can include thymoma,
Masses in the posterior portion of the mediastinum tend to be neurogenic in origin, and in adults tend to be of neural sheath origin including neurilemomas and neurofibromas.[1]
Types
Thymoma
Most common primary anterior mediastinal tumor (20%) in adults but rarely seen in children. It can be classified as lymphocytic, epithelial, or spindle cell histologies, but the clinical significance of these classifications is controversial.[4] Tonofibrils seen under electron microscopy can differentiate thymoma from other tumors such as carcinoid, Hodgkin's, and seminoma. Patients are usually asymptomatic but can present with myasthenia gravis-related symptoms, substernal pain, dyspnea, or cough. Invasive tumors can produce compression effects such as superior vena cava syndrome. Thymomas are diagnosed with CT or MRI revealing a mass in anterior mediastinum. Therapy in stage I tumors consists of surgical resection with good prognosis. Stage II–III requires maximal resection possible followed by radiation. Stage IV disease requires addition of cisplatin-based chemotherapy in addition to those in stage II and III. For those with invasive thymoma, treatment is based on induction chemotherapy, surgical resection, and post-surgical radiation. 5-year survival for invasive thymoma is between 12 and 54% regardless of any myasthenia gravis symptoms.[citation needed]
Lymphoma
Second most common primary anterior mediastinal mass in adults. Most are seen in the anterior compartment and rest are seen in middle compartment.
Common symptoms of a mediastinal lymphoma of include
Of all cancers involving the same class of blood cell, 2% of cases are mediastinal large B cell lymphomas.[8]
Diagnosis
In several editions of Physical Diagnosis,[9] concerning mediastinal tumors the author writes:
- According to Christian1 the mediastinal neoplasms which are neither so rare nor so obscure as to make and cyst.
Many signs and symptoms of a mediastinal tumor do not distinguish between these two principal classes of mediastinal tumor. However, on a
See also
References
- ^ a b "Neurogenic Tumors of the Mediastinum". Retrieved 28 July 2012.
- PMID 14761815.
- PMID 2820323.
- PMID 12067481.
- PMID 12975453.
- S2CID 24939529.
- PMID 16720849.
- ISBN 978-0-7817-5007-3.
Frequency of lymphoid neoplasms. (Source: Modified from WHO Blue Book on Tumour of Hematopoietic and Lymphoid Tissues. 2001, p. 2001.)
- ^ a b Cabot, Richard C (1919). Physical diagnosis (7th ed.). New York: William Wood and Company. p. 527.
External links