Dados do Trabalho


Título

Beyond cardiac limits: Understanding mediastinal masses

Introdução e objetivo(s)

The objective of this study is to describe and illustrate various cases of mediastinal diseases, emphasizing the most common ones. Additionally, the study aims to familiarize radiologists with atypical cases and differential diagnoses, enhancing their proficiency in everyday clinical practice.

Método(s)

The mediastinum, a space in the chest situated between the lungs, houses vital structures, such as the heart, great vessels of the heart, trachea, esophagus, thymus, lymph nodes and nerves. Tumors, both benign and malignant, can originate from any of these structures, posing a diagnostic challenge. Various imaging modalities, including CT and MRI, are effective tools for studying the mediastinum. Our cases are sourced from a quaternary healthcare institution, with daily exposure to highly complex cases, and it serves as a national reference center. The focus of this study is to diagnose masses in the mediastinal region, which are often incidentally discovered in asymptomatic patients, by elucidating fundamental characteristics that assist radiologists. While the analysis of chest X-rays and CT scans is routine for healthcare professionals, this work aims to illustrate mediastinal pathologies, including both the most common and atypical cases, while establishing a diagnostic algorithm.

Discussão

The mediastinum can be anatomically divided into prevascular, visceral and paravertebral compartments according to International Thymic Malignancy Interest Group. This educational exposition examines selected cases of thymoma, neurogenic tumors and benign cysts, which represent 60% of mediastinal masses, as well as thymic neoplasms, teratoma, lymphoma, germ cell neoplasms, lymphangioma and pericardial cyst, among others.

Conclusões

Understanding differential diagnoses enables radiologists to generate hypotheses for common radiological findings in asymptomatic patients. It's important to note that the anatomical location, compression of adjacent structures and image characteristics offer valuable insights.

Palavras Chave

Mediastinum compartments; Mediastinum masses

Arquivos

Área

Tórax

Instituições

INSTITUTO DE RADIOLOGIA DO HOSPITAL DAS CLINICAS DA FACULDADE DE MEDICINA DA UNIVERSIDADE DE SAO PAULO - INRAD/HCFMUSP - São Paulo - Brasil

Autores

ELISA MORAES CARVALHO, LETÍCIA CARDOSO ERN, CAMILA SOARES FRANCO, MÁRCIO VALENTE YAMADA SAWAMURA, RICARDO GUERRINI