Mediastinal and lung masses xrays images radiology.pdf

Mediastinal and lung masses. Xray image Gallery

1. MEDIASTINAL MASSES AND
LUNG COLLAPSE

4. MEDIATINAL MASSES

Less than 5% of enlarged thyroid glands
in the neck extend into the mediastinum
produce a retrosternal goitre.

7. THYMOMA:

It is seen as an anterior mediastinal mass on chest
x-ray in adult patient.

Thymoma is often asymptomatic.
•About 10-25% of pt. with myasthenia gravis have
a thymoma.
•About 25-50 % of pt. with a thymoma have a
myasthenia

8. Thymoma appears as a well-defined round
or oval soft tissue mass projects to one
side of the anterior mediastinum when
large.
It is may be undetectable on the chest x-ray
when small.
The diagnosis of thymoma is confirmed by
CT or MRI.

10. GERM CELL TUMORS:

Benign include dermoid cyst and benign teratoma.
30% are malignant include seminoma, embryonal cell
carcinoma, choriocarcinoma and endodermal sinus
tumor.

Germ cell tumors are usually seen as an incidental
anterior mediastinal mass on chest x-ray.

Young adult.
It is well defined or oval mass usually projects to only
one side of the anterior mediastinum.

Diagnosis is confirmed by CT or MRI.

14. MORGAGNI’S HERNIA:

It is usually seen as an anterior mediastinal mass
on chest x-ray.
Adult patient.
90% situated in the right anterior cardiophrenic
angle.
This can be difficult to differentiate it from an
epicardial fat pad or a pleuropericardial cyst.
Diagnosis is confirmed by CT, barium follow
through or barium enema.

20. LIPOMA / LIPOSARCOMA:

Rare tumor and asymptomatic seen in the
anterior or posterior mediastinum.

Diagnosis is confirmed by CT which shows
a solid mass with fat attenuation.

22. MEDIASTINAL LYMPHADENOPATHY:

It is common and can be due to metastatic disease,
lymphoma, leukemia, sarcoidisis, T.B.,
histoplasmosis, other infections and
inflammatory conditions.

It appears as a widening of the right paratracheal
strip, a bulge in the aorto-pulmonary window,
lateral displacement of the azygo-esophageal
line, lobulated widening of mediastinum and
lobulated hilar soft tissue masses.

Diagnosis is confirmed by CT scan.

27. THORACIC AORTIC ANEURYSM:

It is seen as a widening of the mediastinum
or as a well defined round or oval soft tissue
mass in any part of the mediastinum.

Diagnosis is confirmed by CT or MRI.

29. NEUROGENIC TUMOR:

It is seen as an incidental posterior mediastinal
mass on chest x-ray.

Child or young adult.

It appears as a well defined round or oval soft
tissue mass in the paravertebral gutter which
usually projects to only one side of the posterior
mediastinum.

Diagnosis is confirmed by MRI or CT scan.

32. COLLAPSE (atelectasis)

It is loss of volume or lobe of the lung due to:

* Bronchial obstruction
* Pneumothorax or pleural effusion
* Fibrosis of a lobe (usually TB)
* Bronchiectasis
* Pulmonary embolism

33. Causes of collapse:

I. Collapse due to bronchial obstruction:
* Collapse due to bronchial wall lesions: primary
carcinoma, carcinoid, endobronchial TB.
* Collapse due to intralumenal occlusion: mucus
plug, inhaled FB.
* Collapse due to invasion or compression by
adjacent masses: malig. tumor, enlarged L.N.
II. Collapse in association with pleural abnormality:
* Large pneumothorax.
* Massive pleural effusion.
III. Collapse due to fibrosis or bronchiectasis.
IV. Collapse due to pulmonary embolus.

34. Signs of collapse:

* Displacement of the structures
* Collapsed lobe shadow
* Silhouette sign

35. Diagnosis of collapse:

Collapsed shadow like consolidation due to
decrease in lobe volume.

Silhouette sign that mediastinal and diaphragmatic
borders will be ill defined adjacent to the collapsed
lung.

The mediastinum and diaphragm move toward the
collapsed lobe.

In whole lung collapse the entire hemithorax is
opaque and there is mediastinal and tracheal shift.

36. Diagnosis of pneumothorax is obvious, but if
there is a large pleural effusion with pul.
collapse, it may be defficult to diagnose the
collapse on CXR.

CT shows lobar collapse very well.