page1. IN THE NAME OF GOD. Mediastinal Mass. ANATOMY. The mediastinum is a narrow, vertically oriented structure that resides between the medial parietal pleural layers of the lungs. Mediastinal Divisions. superior anterior middle posterior.
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The following characteristics indicate that a lesion originates within the mediastinum:
Unlike lung lesions, a mediastinal mass will not contain air bronchograms.
The margins with the lung will be obtuse.
Mediastinal lines (azygoesophageal recess, anterior and posterior junction lines) will be disrupted.
There can be associated spinal,costal or sternal abnormalities.
Higher-grade thymomas(types B3 and C) tend to show larger size, more irregular margins, heterogeneous enhancement, regions of necrosis, mediastinal nodal metastases, and calcification.
Invasion of the thymic capsule 33% to 50% of patients. In the majority of these patients, this determination cannot be made by CT or MR .
Local invasion of pleura, lung, pericardium, chest wall, diaphragm, and great vessels occurs in 10% to 15% of patients.