Mediastinal Tumors: A Clinicopathological Analysis

Abstract

Between January 1993 and June 2003, 106 patients underwent surgical treatment of a mediastinal mass. Ages ranged from 6 months to 62 years, with peak incidence in the third and fourth decade of life (56%). The male to female ratio was 1.9:1. The anterosuperior mediastinum was involved in 76 patients (72%), middle mediastinum in 13 (12%), and posterior mediastinum in 17 (16%). Myasthenia gravis was present in 27% of cases. Complete surgical excision was possible in 68% of patients. Histopathologically, 41 (39%) patients had thymic pathology, 31 (29%) had lymphoma, 14 (13%) had germ cell tumors, 12 (11%) had neurofibroma, 4 (4%) had ganglioneuroma, 2 (2%) had bronchogenic cyst, and 1 each had thymic cyst and mesothelioma. The overall mortality was 3.8%.

Histopathological Profile of Mediastinal Lesions- A Five-Year Study From a Tertiary Care Centre in South India

“…The peak age of these lesions were in the 4 th and 5 th decades and they had an approximate M: F ratio of 1: 1. This was in concordance with the studies conducted independently by Dasgupta et al and Shrivastava et al 4,5 In this study 66% (103) of the lesions were found in the anterior mediastinum, 12% (33) in the middle mediastinum, 8% (13) in the posterior mediastinum and 5% (8) in the superior mediastinum. A similar study by Sharma et al showed 36.7% involvement of the anterior compartment followed by middle (33%) and posterior (30%).…”

“…This was in concordance with study by Shrivastava et al 5 They showed a M: F ratio of 1: 0.9 with majority 79% (38 cases) presenting with pressure symptoms like cough, dyspnoea and vague chest discomfort, while 21% (10) of them presented with paraneoplastic syndromes like myasthenia gravis. Most of them were in the anterior mediastinum (46, 95.8%) and two cases showed extension to the superior mediastinum (2, 4.2%).…”

“…This was in concordance with Shrivastava et al and Bastos et al 5,9 Hypercalcaemia and Hyperparathyroidism was seen in the ectopic parathyroid tumours of the thymus.…”

Clinical Profile of Mediastinal Masses

“…Among malignant cases NHL was most common and this was similar to other studies by Akshatha Rao et al 3 and Vaziri et al 4 and Shrivastav et al 12 In other studies like Cohen et al 9 , Davis et al 8 , Singh et al 6 and Dubashi et al 7 thymomas were most commonly followed by lymphomas and bronchogenic carcinomas. In Nasit et al 13 study, the most common tumour was metastatic carcinoma (38%) followed by NHL.…”

Primary Marginal Zone Lymphoma in the Posterior Mediastinum with Pleural Involvement

“…Malignant lymphoma presents as an anterior, superior, or middle mediastinal mass, in this order of frequency (1)(2)(3). Mediastinal malignant lymphomas mainly arise from a lymph node or the thymus, with anterior and middle mediastinal predilection.…”