Imaging strategy Localized to mediastinum Localize within the mediastinum
Localize to the mediastinum Unlike lung lesions, a mediastinal mass will not contain air bronchograms. The margins with the lung will be obtuse. Mediastinal lines (azygoesophageal recess, anterior and posterior junction lines) will be disrupted. There can be associated spinal, costal or sternal abnormalities.
LEFT: A lung mass abutts the mediastinal surface and creates acute angles with the lung. RIGHT: A mediastinal mass will sit under the surface of the mediastinum, creating obtuse angles with the lung.
The lesion on the left was a pancoast tumor. The lesion on the right was a thymoma, located within the anterior mediastinum.
Bronchogenic cyst – A benign growth with respiratory origins. Lymphadenopathy mediastinal – An enlargement of the lymph nodes. Pericardial cyst – A benign growth that results from an "out- pouching" of the pericardium (the heart’s lining). Thyroid mass mediastinal – Usually a benign growth, such as a goiter. These types of tumors can occasionally be cancerous. Tracheal tumors – These include tracheal neoplasms and non- neuplastic masses, such as tracheobronchopathia osteochondroplastica (benign tumors). Vascular abnormalities including aortic aneurysm and aortic dissection. Middle mediastinum
Mediastinal widdening >8 cm in the aortic knob depression of the left main-stem bronchus deviation of the naso-gastric tube to the right apical pleural haemoatoma (cap) disruption of the calcium ring in the aortic knob (broken-halo) Aortic injury in blunt trauma