Mediastinal Mass Symptoms, Causes And Diagnosis
A mediastinal mass can be discovered on imaging of the chest. This is a mass located in the central chest between the lungs. A mediastinal mass can be found on X-rays, CT and MRI studies of the chest.
What is a mediastinal mass?
A mediastinal mass is located in the mediastinum of the chest. The mediastinum is the central part of the chest between the lungs. We divide the mediastinum into different compartments called anterior, middle, and posterior.
Mediastinal mass on CT scan
CT is the most common imaging test to image the mediastinum. CT can tell us more details about the mass. CT tells us exactly where the mass is and what structures it involves.
CT tells us what the consistency of the tissue is. This can be solid, fatty, calcified or cystic. Some tumors have a mixture of tissue consistencies.
CT tells us if the mass is invading other structures. We also see if the mass has spread to other parts of the chest in the case of cancer.
Where is a mediastinal mass located?
The mediastinum is the central part of the chest between the lungs. It goes from the front of the chest to the spine. A mass between the lungs is called a mediastinal mass. Please see this article for more details about the mediastinum: mediastinum definition.
Anterior mediastinal mass
An anterior mediastinal mass involves the front part of the mediastinum by the sternum. For more information please refer to this article: anterior mediastinal mass in radiology.
Causes: Thymus related masses such as thymoma, thymic cacrinoma, thymic cyst, thymic hyperplasia or enlargement.
Lymphoma or cancer of the lymphatic system can present as mass in this part of the mediastinum.
Germ cell tumors involve primitive cells. Some of these can be seminomas, yolk sac tumors, teratomas to name some.
Masses related to the thyroid or parathyroid glands. The thyroid gland can extend into the anterior mediastinum when enlarged.
Vascular masses such as aneurysms.
Posterior mediastinal mass
A posterior mediastinal mass involves the part of the central chest near the spine.
Causes:
Masses which arise from the nervous system are most common here. Variety of cancers such as lymphoma, esophageal tumors, sarcomas, and metastasis (spread of cancer) are also possible.
You can get infections here related to the spine. Abscesses (collections of pus) adjacent to the spine can occur.
Aneurysms of the aorta can be found here.
Cysts that you can be born with. These include bronchogenic cysts and esophageal duplication cysts to name a few.
Middle mediastinal mass
A middle mediastinal mass involves the part of the mediastinum between the anterior and posterior mediastinum.
Causes: This is most commonly seen with enlarged lymph nodes which can be from cancer or infection. Aneurysms, cysts, nerve tumors, and abscess are some other possibilities.
Mediastinal lymphadenopathy
Mediastinal lymphadenopathy is when there are abnormal lymph nodes in the mediastinum. We can identify this on imaging when the lymph nodes are large or abnormal in their appearance.
Normal appearing lymph nodes on imaging can have disease as well. This is most common with cancer such as lymphoma, spread of cancer from other locations in the body, and various infections.
Symptoms of mediastinal mass
This depends on where the mass is and what structures are involved. Symptoms can include: cough, wheezing, chest pain, coughing up blood, fevers, chills in addition to others.
Can a mediastinal mass be lymphoma?
Yes. Mediastinal lymphomas arise from lymph nodes or the thymus. These are solid tumors or large lymph nodes. Most masses are in the anterior or middle mediastinum.
Mediastinal mass treatment
The treatment of mediastinal masses depends on the underlying diagnosis. Some lesions such as cysts can be left alone or followed closely. Others may need surgery or systemic treatment for cancer.
Mediastinal mass: summary
Mediastinal masses are found in the central chest between the lungs. The mediastinum is divided into anterior, middle and posterior compartments. The location of the mass helps us with the underlying diagnosis. CT and MRI can help with the diagnosis of a mediastinal mass.
