Evaluation of Mediastinal Tumours: A Study of 50 Cases

Abstract

INTRODUCTION Mediastinum is a site for neoplastic and non-neoplastic lesions and many of them present as mediastinal mass. The location and composition of these lesions are critical in arriving at a clinical diagnosis. This study of different mediastinal masses is aimed to find out frequency of malignancy, their compartmental distribution and characteristics through computed tomography. MATERIALS AND METHODS A prospective study was conducted at Government Medical College, Thrissur, India, during the period 2010-2012 with a total of 50 patients with suspected mediastinal masses. All patients were subjected to investigations like chest X-ray, CT scan along with guided fine needle aspiration/biopsy for definite tissue diagnosis. The major variables were age, clinical symptoms, mass location, imaging studies, and tissue pathology. RESULT Fifty patients enrolled in this study were analysed and compared with existing studies in the literature. 34 cases (68%) were malignant and 16 cases (32%) were benign. Majority of the lesions were seen in the anterior compartment, followed by posterior compartment. Bronchogenic carcinoma and lymphoma were the common malignant tumours seen in the anterior and middle compartments of the mediastinum, whereas neurogenic tumours, mostly benign, were the common tumours in the posterior compartment. CONCLUSION CT scan is an effective tool in evaluating mediastinal masses. Moreover, sampling the mass is important in obtaining pathological diagnosis. Surgery, radiotherapy and chemotherapy either as single or in combination are the main modalities of treatment. Accurate preoperative pathological diagnosis, invasion and infiltration of the tumour were the key to successful treatment.