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Clinical Approach: Recommendations for the Clinicians

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The Mediastinal Mass

Part of the book series: Current Clinical Pathology ((CCPATH))

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Abstract

Mediastinal masses include a wide variety of entities both neoplastic and not often presenting with several clinical and pathological features thus constituting a diagnostic challenge for clinicians.

In about half of cases, a mediastinal mass can be an incidental finding in patients who undergo imaging studies for other reasons.

Local symptoms, if present, may be due to compressive or infiltrative effects of the mass, while systemic symptoms are due to release of hormones, cytokines, and antibodies. In general, malignant lesions are more likely to be symptomatic.

In most patients, a combination of demographic information, clinical presentation, and imaging features allows a presumptive diagnosis, which can be definitely addressed only after tissue biopsy.

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References

  1. Priola AM, Priola SM, Cardinale L, et al. The anterior mediastinum: diseases. Radiol Med. 2006;111(3):312–42.

    Article  CAS  Google Scholar 

  2. Kim Y, Lee KS, Yoo JH, et al. Middle mediastinal lesions: imaging findings and pathologic correlation. Eur J Radiol. 2000;35(1):30–8.

    Article  CAS  Google Scholar 

  3. Occhipinti M, Heidinger BH, Franquet E, et al. Imaging the posterior mediastinum: a multimodality approach. Diagn Interv Radiol. 2015;21(4):293–306.

    Article  Google Scholar 

  4. Athanassiadi KA. Infections of mediastinum. Thorac Surg Clin. 2009;19(1):37–45.

    Article  Google Scholar 

  5. Davis RD Jr, Oldham HN Jr, Sabiston DC Jr. Primary cysts and neoplasms of the mediastinum: recent changes in clinical presentation, methods of diagnosis, management, and results. Ann Thorac Surg. 1987;44(3):229–37.

    Article  Google Scholar 

  6. Wilson LD, Detterbeck FC, Yahalom J. Superior vena cava syndrome with malignant causes. N Engl J Med. 2007;356:1862–9.

    Article  CAS  Google Scholar 

  7. Cohen R, Mena D, Carbajal-Mendoza R, et al. Superior vena cava syndrome: a medical emergency? Int J Angiol. 2008;17(1):43–6.

    Article  Google Scholar 

  8. Shelly S, Levin NA, Altman A, et al. Thymoma and autoimmunity. Cell Mol Immunol. 2011;8(3):199–202.

    Article  CAS  Google Scholar 

  9. Azarow KS, Pearl RH, Zurcher R, et al. Primary mediastinal masses: a comparison of adult and pediatric populations. J Thorac Cardiovasc Surg. 1993;106:67.

    CAS  PubMed  Google Scholar 

  10. Barlow LJ, Badalato GM, McKiernan JM. Serum tumor markers in the evaluation of male germ cell tumors. Nat Rev Urol. 2010;7(11):610–7.

    Article  CAS  Google Scholar 

  11. Takahashi K, Al-Janabi NJ. Computed tomography and magnetic resonance imaging of mediastinal tumors. J Magn Reson Imaging. 2010;32(6):1325–39.

    Article  Google Scholar 

  12. Gupta S, Seaberg K, Wallace MJ, et al. Imaging-guided percutaneous biopsy of mediastinal lesions: different approaches and anatomic considerations. Radiographics. 2005;25(3):763–86.

    Article  Google Scholar 

  13. Strickler JG, Kurtin PJ. Mediastinal lymphoma. Semin Diagn Pathol. 1991;8:2–13.

    CAS  PubMed  Google Scholar 

  14. Herrada J, Cabanillas F, Rice L, et al. The clinical behavior of localized and multicentric Castleman disease. Ann Intern Med. 1998;128(8):657–62.

    Article  CAS  Google Scholar 

  15. Takeda S, Miyoshi S, Minami M, et al. Clinical spectrum of mediastinal cysts. Chest. 2003;124:125–32.

    Article  Google Scholar 

  16. Duwe BV, Sterman DH, Musani AI. Tumors of the mediastinum. Chest. 2005;128(4):2893–909.

    Article  Google Scholar 

  17. Hainsworth J. Diagnosis, staging, and clinical characteristics of the patient with mediastinal germ cell carcinoma. Chest Surg Clin N Am. 2002;12:665–72.

    Article  Google Scholar 

  18. Reeder LB. Neurogenic tumors of the mediastinum. Semin Thorac Cardiovasc Surg. 2000;12(4):261–7.

    Article  CAS  Google Scholar 

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Correspondence to Floriana Morgillo .

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Ciardiello, F., Morgillo, F., Viscardi, G. (2018). Clinical Approach: Recommendations for the Clinicians. In: Franco, R., Zito Marino, F., Giordano, A. (eds) The Mediastinal Mass. Current Clinical Pathology. Humana, Cham. https://doi.org/10.1007/978-3-319-90368-2_2

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  • DOI: https://doi.org/10.1007/978-3-319-90368-2_2

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  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-319-90367-5

  • Online ISBN: 978-3-319-90368-2

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