Mediastinal Masses in Children: Radiologic-Pathologic Correlation

Abstract

Most pediatric masses in the chest are located in the mediastinum. These masses are often initially detected incidentally on chest radiographs in asymptomatic children, although some patients may present with respiratory symptoms. At chest radiography, the mediastinum has been anatomically divided into anterior, middle, and posterior compartments. However, with the International Thymic Malignancy Interest Group classification scheme, which is based on cross-sectional imaging findings, the mediastinum is divided into prevascular, visceral, and paravertebral compartments. In the prevascular compartment, tumors of thymic origin, lymphomas, germ cell tumors, and vascular tumors are encountered. In the visceral compartment, lymphadenopathy and masses related to the foregut are seen. In the paravertebral compartment, neurogenic tumors are most common. Using the anatomic location in combination with knowledge of the imaging and pathologic features of pediatric mediastinal masses aids in accurate diagnosis of these masses to guide treatment and management decisions.

Pediatric Mediastinal Lymphatic Malformation: Misdiagnosis Analysis and Literature Review

“…Analyzing the composition of the lesion, the presence of intertumoral fat within the anterior mediastinal mass (measured at -40 HU to -120 HU on CT) was highly suggestive of benign teratoma (15)(16)(17), similar to the ndings of the present study. Although fat-uid levels and the presence of bone or teeth within the tumor are highly speci c for the diagnosis of teratoma, this sign is rare and not of outstanding value for daily clinical use.…”

“…Among primary tumors of the mediastinum in children, when teratomas undergo cystic transformation, they are not easily differentiated from MCLMs that are independently solitary in the mediastinum. Enhanced CT is the imaging modality of choice for the evaluation and characterization of most mediastinal lesions (15). Although the nal de nitive clinical diagnosis of both is currently dependent on pathological ndings or interventional diagnostic puncture, enhanced CT examination is of signi cant value in analyzing the nature of the lesion and evaluating the relationship of adjacent vascular tissue.…”

Clinical radiomics-based machine learning versus three-dimension convolutional neural network analysis for differentiation of thymic epithelial tumors from other prevascular mediastinal tumors on chest computed tomography scan

“…Exclusion criteria were patients younger than 20-year-old, missing imaging data, or metastatic prevascular mediastinal tumors. The patients younger than 20-year-old were excluded because the most common types of tumors in this age group are lymphomas and malignant germ cell tumors, and the rare occurrence of thymic epithelial tumors (TET) does not have much impact on histological classification of tumors ( 13 ). Clinical data including age, sex, myasthenia gravis (MG) symptoms and pathologic diagnosis were collected.…”

Isolated Malignant Pleural Effusion in a Child: Unusual Presentation of Acute Leukemia

“…In pediatric cases of malignant pleural effusion, the presentation typically involves a mass in the lung or mediastinum. However, cases without any mass or clinical features indicating leukemia have not been reported [9]. The presented case adds complexity as the patient initially exhibited febrile illness followed by respiratory symptoms, leading to the initial consideration of an infectious etiology, with empyema being the likely diagnosis.…”