Bengal Physician Journal

Register      Login

VOLUME 11 , ISSUE 1 ( January-April, 2024 ) > List of Articles

Original Article

The Clinico-pathology Loci, Diagnosis and Management of Mediastinal Masses: A Retrospective Study in a Tertiary Care Hospital

Shilpa Basu Roy, Birupaksha Biswas, Subesha Basu Roy

Keywords : Hydratid cyst, Lymphoma, Mediastinum, Mediastinal mass, Myasthenia gravis, Pleuro pericardial cyst, Thorax, Thoracic surgery, Thymoma

Citation Information : Roy SB, Biswas B, Roy SB. The Clinico-pathology Loci, Diagnosis and Management of Mediastinal Masses: A Retrospective Study in a Tertiary Care Hospital. Bengal Physician Journal 2024; 11 (1):14-17.

DOI: 10.5005/jp-journals-10070-8038

License: CC BY-NC 4.0

Published Online: 18-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Background: The mediastinum is known to be a space within the domain of the thorax housing the important organs, blood vessels, nerves, lymphatics along with the surrounding connective tissue, where the International Thymic Malignancy Interest Group (ITMIG) classification system based on cross sections derived by the CT into prevascular mediastinum, visceral mediastinum and paravertebral mediastinum. The diagnosis of mediastinal neoplasia and it is necessary treatment often becomes challenging owing to the complex anatomy. With the advancement in cross-sectional imaging using CT scan with or without contrasts, diffusion weighted and chemical shift MR imaging, FDG-PET scan, guided biopsies with microscopic examination aided by special stains, the diagnosis of such become unconstrained. Materials and methods: In our aim to focus on the clinico-pathology locus, diagnosis and treatment of mediastinal neoplasia, we perform a retrospective study in a tertiary care hospital spanning from January 2020 to December 2022, for a period of 3 years in the CTVS Department (IPGMER and SSKM) Hospital, with the number being 42 who had mediastinal masses and they were characterized using the age, gender, clinical stigmata, and were subjected to cross-sectional imaging of the thorax, guided biopsies, histopathological examination, targeted treatment using surgery or the standard therapeutic approach. Result: Statistical analysis was done using the software SPSS version 20/21, revealing 28 males and 14 females (M:F = 2:1) 28.57% patients for hydatid cyst, 26.19% patients of thymoma, 7% patients for thymic malignancy, 11.90% of patients for lymphoma, 14.28% for pleuropericardial cyst, 9.52% for dermoid, and 2.38% for teratomas. The follow-up period ranged from 1 to 5 years and the mean follow-up was 2.33 ± 1.28 (Mean ± SD). lesions were mostly found in the anterior compartment of the mediastinum (20%) with thymoma being the commonest followed by hydatid, pleuropericardial cysts, dermoid and the lymphoma. Conclusion: Since they are deemed to be slow growing and gradually would compress the great vessels, heart, spinal cord, vocal cords, stellate ganglion, brachial plexus, superior vena cava, or the diaphragm to explain the symptomology, we have generously discussed and documented the atypical lesions too which must be taken as the differential diagnosis namely atypical lesions namely retrosternal goiters invading the mediastinum, Langerhans cell histiocytosis, mesothelioma, squamous cell carcinoma, adenocarcinomatous lesion, pleomorphic sarcomas, melanomas, primary pleural liposarcoma, malignant epithelioid gastro intestinal stromal tumors, and even solitary fibrous tumors. To sum up, specific radiology with the needle diagnosis and targeted treatment would henceforth be a logical approach to aim a better patient care.

PDF Share
  1. Carter BW, Benveniste MF, Madan R, et al. ITMIG classification of mediastinal compartments and multidisciplinary approach to mediastinal masses. Radiographics 2017;37(2):413–436. DOI: 10.1148/rg.2017160095.
  2. Ghigna MR, Thomas de Montpreville V. Mediastinal tumours and pseudo-tumours: A comprehensive review with emphasis on multidisciplinary approach. Eur Respir Rev 2021;30(162):200309. DOI: 10.1183/16000617.0309-2020.
  3. Shahana B, Ayub II, Dhanasekar T, et al. Clinico-pathological and radiological spectrum of mediastinal masses in a tertiary care center: A cross-sectional study. Cureus 2023;15(4):e37922. DOI: 10.7759/cureus.37922.
  4. Sridhar R, Narasimhan R, Sundararajan L, et al. Clinicoradiopathological features among mediastinal masses. Indian J Respir Care 2021;10: 41–46.
  5. Nasit JG, Patel M, Parikh B, et al. Anterior mediastinal masses: A study of 50 cases by fine needle aspiration cytology and core needle biopsy as a diagnostic procedure. South Asian J Cancer 2013;2(1):7–13. DOI: 10.4103/2278-330X.105872.
  6. Ahuja J, Strange CD, Agrawal R, et al. Approach to imaging of mediastinal masses. Diagnostics 2023;13(20):3171. DOI: 10.3390/diagnostics13203171.
  7. Ackman JB, Chung JH, Walker CM, et al. ACR Appropriateness Criteria® Imaging of mediastinal masses. J Am Coll Radiol 2021;18(5S):S37–S51. DOI: 10.1016/j.jacr.2021.01.007.
  8. Shamsuddin F, Khadilkar UN, Saha D. Unusual lesions of the mediastinum. Lung India 2015;32(6):566–571. DOI: 10.4103/0970-2113.168104.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.