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Chest -- mediastinal masses

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Where is the anterior mediastinum?
Sternum posteriorly to anterior surface of great vessels, and the pericardium. Thus, it is much thinner as you go inferiorly.
What are anterior mediastinum mass categories?
Thymoma (but instead, think thymic processes)


Teratoma (yes, but think germ cell neoplasms to be more inclusive)


Thyroid (yes, but don't forget parathyroid)


Terrible lymphoma (yes, but dont forget other masses of the lymph nodes)


Diaphragmatic abnormalities
What is a classic auxilliary finding in thymoma?
Pleural drop met to the costophrenic angle
What are thymic cysts associated with?
HIV

Infection

Neoplasm


These are typically thick-walled
How do they appear on x-ray?
Often have eggshell calcification. Looks like could be aortic aneurysm, but you see a normal aortic arch.
Fatty anterior mediastinal mass with some strands of soft tissue density running through it?
Thymolipoma
Nondescript anterior mediastinal soft tissue mass?
Thymoma
Thymic carcinoid (looks just like invasive thymoma)
Lymphoma
Teratoma
Enlarged thymus keeping thymic shape in person older enough that should no longer see thymus?
Thymic hyperplasia
Causes of thymic hyperplasia?
Hyperthyroidism



Rebound hyperplasia from chemo
Older age group: Teratoma or thymoma?
Thymoma older average age. Teratoma occurs 20-30
Cystic area within soft tissue mass?
Same appearance of thymic, but certain types of Hodgkins can do it

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