Clinicoradiopathological features among mediastinal masses

Abstract

Background: The mediastinum is a place where various benign and malignant diseases usually manifest as mass and present as interesting diagnostic challenge. The purpose of this study was to describe clinical features, radiological, and pathological information of mediastinal masses to help have an organized approach to diagnosis of mediastinal masses. Patients and Methods: This was a prospective, descriptive cross-sectional study conducted over a period of 1 year at our hospital after obtaining ethical committee clearance. Patients with mediastinal masses fulfilling the inclusion criteria were enrolled in the study. Patient's clinical history, radiological features, techniques used to obtain specimens, and cyto-histopathology results from data collected in our total study population were analyzed. Results: A total of 73 patients with mediastinal masses were included. Thirty-three of them (45.2%) were malignant and 32 (43.8%) were nonmalignant masses. The masses were commonly located in the middle compartment (n = 42 [57.5%]), followed by anterior compartment (20 [27.4%]), posterior compartment (8 [11%]), and multicompartment (3 [4.1%]). Among middle mediastinal masses, infectious masses were 14 (33.3%), followed by 11 (26.2%) malignant masses. Anterior mediastinal masses were predominantly malignant in nature (90%). Nature of mass was inconclusive in eight (11%) patients. Conclusion: Clinical history, anatomical position, and imaging characteristics allow the correct diagnosis in many cases when it is combined with histopathology. The newer endoscopic techniques such as endoscopic ultrasound-guided fine-needle aspiration or biopsy are generally preferred in view of lesser complications and ease compared to more invasive surgical procedures for mediastinal mass evaluation.

Keywords

• endobronchial ultrasound
• endoscopic ultrasound
• mediastinal lymphadenopathy
• mediastinal mass