Anterior mediastinal mass Radiology

Superior mediastinum - wikidoc

Anterior Mediastinal Masses : American Journal of

Chest radiography can show an anterior mediastinal mass directly or indicate the presence of the mass indirectly by its compression or displacement of adjacent structures. However, radiography is of limited value for characterizing the lesion Mediastinal masses may be caused by a wide variety of neoplastic and non-neoplastic pathologies. It is helpful to identify the location of the mass since this significantly reduces the breadth of the differential diagnosis An anterosuperior mediastinal mass can be caused by neoplastic and non-neoplastic pathology. As their name suggests, they are confined to the anterior mediastinum, that portion of the mediastinum anterior to the pericardium and below the level of the clavicles. The differential diagnosis for an anterior mediastinal mass includes

Mediastinal mass Radiology Reference Article

  1. Anterior mediastinal masses are detectable on chest x-rays when they distort the normal mediastinal contours or fill the retrosternal clear space on the lateral view. CT is often required for detection and may provide specific diagnostic features or important staging information
  2. Chest radiography can show an anterior mediastinal mass directly or indicate the pres - ence of the mass indirectly by its compression or displacement of adjacent structures
  3. The anterior mediastinum is the part closest to the sternum or breast bone and below the collar bone extending down to the covering of the heart. Abnormalities of this compartment of the chest can be predicted based on the contents which include: the thymus, lymph nodes and in abnormal cases, an enlarged thyroid gland
  4. Anterior mediastinal germ cell tumors Dr Bahman Rasuli ◉ and Assoc Prof Frank Gaillard ◉ ◈ et al. Germ cell tumors are one of the causes of anterior mediastinal mass, and any of the germ cell histologies may be identified. They can therefore be divided histologically into
  5. The anterior mediastinum contains the following structures: thymus, lymph nodes, ascending aorta, pulmonary artery, phrenic nerves and thyroid. The most common lesions that you will see in the anterior mediastinum will either be of thymic or lymph node origin. Even the germ cell tumors arise from the pluripotent cells of the thymus

Fig. 1 — Lateral chest radiograph shows three mediastinal compartment locations. Anterior mediastinal compartment is area surrounded by sternum anteriorly and anterior margin of pericardium posteriorly At radiography, cystic teratomas usually appear as a sharply marginated, round or lobulated anterior mediastinal mass that extends to one side of the midline. Calcification, ossification, or even teeth may be visible on chest radiographs (, 34) Computed tomography (CT) is the study of choice for evaluating disease in the anterior mediastinum. Mediastinal CT is usually performed with intravenously administered contrast material, and spiral CT is the preferred technique for evaluating a mediastinal mass The 5 T's of Anterior Mediastinal Masses. This mnemonic has been used commonly to recall the five most common anterior mediastinal masses: 1. T - Thymus - Thymoma. 2. T - Thyroid - Ectopic Thyroid masses. 3. T - Thoracic Aorta - Dilated or anuerysm of the ascending aorta. 4

The most common thymic abnormality that manifests as an anterior mediastinal mass is thymoma (Box 16-2). Thymomas account for most anterior mediastinal masses in adults and typically occur as incidental findings in otherwise healthy individuals A: Anterior mediastinum. Hilar vessels seen through the mass, and right heart border obliterated. Q: What is the visibility of hilar vessels through a mass known as? What does it imply when present. show answer. A: Hilum overlay sign Plain radiograph Presents as an anterior mediastinal mass. On plain radiographs, they are often seen as a well-defined, lobulated soft tissue density slightly towards one side of the mediastinum. Can demonstrate associated calcification (commonly amorphous/flocculent) It should be noted that acquired thymic cysts, particularly those of thymic origin in the anterior mediastinum, are more likely to be multilocular (26 - 30). The T1 signal intensity of benign mediastinal cysts can be intermediate to hyperintense, depending on the amount of hemorrhage and proteinaceous material within the lesion (23, 31)

Differential for an anterosuperior mediastinal mass

Typical anterior mediastinal contents include thymus, mediastinal fat, lymph nodes, and the left brachiocephalic vein. The middle mediastinal, or visceral, compartment includes the remainder of vascular structures: superior vena cava, ascending and descending thoracic aorta, and intra-pericardial pulmonary arteries The PA radiograph shows a very large mass extending laterally from the left side of the mediastinum (arrows). Its location in the anterior mediastinum is confirmed on the lateral view which shows that the mass (outlined in yellow) is displacing the trachea (blue lines) posteriorly Mediastinal masses are stratified by mediastinal compartment, as recently re-defined by the International Thymic Malignancy Interest Group (ITMIG) on the basis of CT, rather than chest radiography (CXR). 5 The prevascular (anterior) mediastinal compartment includes structures anterior to the pericardium and ascending aorta. The visceral (middle.

Anterior mediastinal masses in the prevascular region can obliterate the anterior junction line, although it is usually the preservation of more posterior lines at radiography that helps identify the location of an anterior mediastinal mass. Radiology 1968; 90(5): 990-994 Localization of mediastinal masses to specific compartments, together with demographic and clinical information, allows formulation of a focused differential diagnosis and helps guide further evaluation and management. Anterior, middle, and posterior mediastinal compartments have been used for decades in radiographic interpretation

One study analyzing 127 anterior mediastinal masses of various etiologies demonstrated that CT was equal or superior to magnetic resonance imaging (MRI) in the diagnosis of anterior mediastinal masses except for thymic cysts. 14 Indeed, when a cystic mass is suspected or is to be investigated, MRI is the most useful imaging modality, because. Mediastinal masses are relatively uncommon, yet include a large variety of entities. Some tumors can be diagnosed with confidence based on imaging alone; others when a typical appearance is combined with the right clinical presentation. A structured approach for radiologists is presented to facilita TNB of anterior mediastinal masses is useful in metastatic disease and germ cell tumors. Lymphoma and thymoma are less reliably diagnosed unless immunohistochemical cytologic methods are applied Localization of mediastinal masses on CXR is a two-part job. The first part is to determine that a mass is actually mediastinal, and the second part is to place it in the anterior, middle, or posterior mediastinum. Several signs place a mass in the mediastinum. Configuration of the interface of the mass with adjacent lung is sometimes helpful Anterior Mediastinal Mass On CT. The mediastinum is the compartment of the chest between the lungs. The anterior mediastinum is the part closest to the sternum or breast bone and below the collar bone extending down to the covering of the heart. Abnormalities of this compartment of the chest can be predicted based on the contents which include.

Anterior Mediastinal Mass Radiology Ke

Anterior Mediastinal Masses August 2014, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, D'Cruz IA, Feghali N, Gross CM. Echocardiographic manifestations of mediastinal masses compressing or encroaching on the heart. Echocardiography 1994; 11:523-533 [Google Scholar] 4. Devaraj. Imaging of anterior mediastinal masses Leslie E. Quint Department of Radiology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0030, USA Corresponding address: Leslie E. Quint, MD, Professor, Department of Radiology, University of Michigan Health System

Review of anterior mediastinal masses for radiology board review. Download the free study guide on this topic by clicking here. Home. Podcast Episodes . The Radiology Review Journal. Study Guides. Top Radiology Books 2021. Top Radiology Programs 2021: Radiology Department Rankings Conventional radiology is the first imaging technique to perform in the suspicion of an anterior mediastinal mass; in fact, a large anterior mediastinal mass is readily identified by chest radiography as it typically appears as an extra soft tissue mass or opacity

LearningRadiology - thymoma, thymic, mass, neoplasm

Anterior Mediastinal Masse

of anterior mediastinal tumors except for thymic cyst. CT sh ld b th d lit f h i f ll i h thould be the modality of choice following chest radiography Noriyuki Tomiyama at all, J Europ Radiology 2009 www.downstatesurgery.or Anterior Mediastinal Masses For practical purposes and to facilitate the diagnosis, anterior mediastinal masses in chil-dren can be classified on the basis of their density into the three categories: solid, fatty, and cystic lesions. Solid Lesions Prominent thymus (pseudomass)—The thymus is a bilobed encapsulated organ locate One study that analyzed 127 anterior mediastinal masses from various causes demonstrated that multidetector CT was equal or superior to MR imaging in diagnosis of anterior mediastinal masses except for thymic cysts . For this reason, ITMIG uses multidetector CT as the gold standard/reference modality for defining the mediastinal compartments Imaging of mediastinal abnormalities General considerations. More than half of all mediastinal masses arise from the anterior/prevascular compartment (10,13-21).In many cases, the localization of a lesion to a specific compartment and its detailed characterization on CT is sufficient to make the diagnosis or provide a focused differential diagnosis

Although the true prevalence of mediastinal masses is not known, a 0.9% prevalence of anterior or prevascular mediastinal masses was found among the 2,571 chest CTs of the 51% female cohort of the Framingham Heart Study, with a mean age of 59 years [1]. A 0.73% prevalence of prevascular mediastinal nodules was found on th Anterior mediastinum is the most common location of mediastinal tumors, which include various solid and cystic lesions. The lesion location and CT and MRI features are important in the differential diagnosis. Recently, CT-based mediastinal compartment classification systems were proposed and suggest

Anterior Mediastinal Mass On CT - Radiology In Plain Englis

Approach to the DDX of anterior mediastinal mass: Determine if what you are seeing is a prominent thymus with symmetrically enlarged thymic lobes, if the thymic lobes are asymmetrically enlarged then consider thymoma; If there is fat or calcium in the mass, consider teratom Anterior Mediastinal Mass. There is a large superior / anterior mediastinal mass seen projecting predominently to the left side of the midline and in close contact with the aortic knuckle. On CT, the mass shows some peripheral enhancement and appears to displace the carotid vessels. The differential would include (1) lymphoma (2) teratoma (3. Anterior mediastinal masses may arise from any of these structures. Masses in this region may be discovered as incidental findings on imaging or the patient may present with symptoms due to compression of the airways or the superior vena cava, or because of invasion of nerves such as the vagus or recurrent laryngeal

Anterior mediastinal germ cell tumors Radiology

Abstract. The results of 143 transthoracic needle biopsies (TNBs) in 126 patients with anterior mediastinal masses were compared with the final diagnosis, which was proved with pathologic study (n = 95) or clinicoradiologic methods (n = 31). In the 26 patients with lymphoma, the sensitivity of TNB was 42%; the specificity, 96% Henschke CI, Lee IJ, Wu N, et al. CT screening for lung cancer: prevalence and incidence of mediastinal masses. Radiology 2006;239:586-90. Araki T, Nishino M, Gao W, et al. Anterior Mediastinal Masses in the Framingham Heart Study: Prevalence and CT Image Characteristics. Eur J Radiol Open 2015;2:26-31 Anterior mediastinal mass - Thymoma. The mediastinal contours are bulging due to a large mass - in this case a thymoma. It is possible to determine that this mass is located anteriorly in the mediastinum. The aortic knuckle (mid mediastinum) and both the azygo-oesophageal and descending aorta lines (posterior mediastinum) are clearly visible. Posteroanterior chest radiograph clearly depicts the hila (white arrow), which indicates that the mass is either anterior or posterior to the hila. In addition, the descending aorta is clearly seen (black arrow), indicating that the mass is not within the posterior mediastinum. 11. Chest CT scan demonstrates an anterior mediastinal mass

The Radiology Assistant : Masses differential diagnosi

Germ-cell tumors are the most common cause of a fat containing lesions in the anterior mediastinum and the second most common cause of an anterior mediastinal mass in children. Approximately 90 % are benign germ-cell tumors. Most arise in the thymus mediastinal imaging and masses 1. Radiological imaging of mediastinal masses. Dr. Arun Kumar Singh 2. Introduction The mediastinum is the region in the chest between the pleural cavities that contain the heart and other thoracic viscera except the lungs Boundaries Anterior - sternum Posterior - vertebral column and paravertebral fascia Superior -thoracic inlet Inferior - diaphragm Lateral.

The prevalence of anterior mediastinal masses is 0.9% in the Framingham Heart Study. Those masses may increase in size when observed over 5-7 years. Investigation of clinical significance in incidentally found anterior mediastinal masses with a longer period of follow-up would be necessary 64-year-old woman with reported hypervascular anterior mediastinal mass referred for further imaging evaluation. (A) Axial contrast-enhanced CT image demonstrates enhancing heterogenous mass anterior to the aorta and pulmonary artery. Surgical biopsy was complicated by significant intra-operative hemorrhage

Most anterior mediastinal masses are epithelial tumors. Thymoma is the most commonly occurring anterior mediastinal mass in the adult population, although it accounts for less than one percent of adult malignancies. Benign masses of thymic origin are rare but include thymolipomas, which are characterized by adipose composition, as well as. • Anterior mediastinal masses can look similar to an aortic dissection or aneurysm of chest X-ray • The four most common causes of anterior mediastinal masses are teratomas, thymomas, lymphoma, or thyroid (goiter or neoplasm) • Biopsy is the definitive means of diagnosis for anterior mediastinal masse 15,16 Mature teratomas, which represent approximately 60% to 70% of mediastinal germ cell tumors, are usually well-differentiated and benign. 16 On chest radiography, these are rounded to lobulated, well-defined anterior mediastinal masses that may extend to one side of the midline and may attain large sizes RADIOLOGY: 1-HILUM OVERLAY SIGN: On the chest film there is a mass that has obtuse angles with the mediastinum, so it is a mediastinal mass.The hilar vessels are seen through this mass, so it does not arise from the hilum and probably will arise from the anterior mediastinum.The anterior location was confirmed on a CT.Most commonly this will be. Hilum can be seen through mass this must be an anterior mediastinal mass because it overlaps rather than pushes out the main pulmonary arteries This particular example is a thymoma 35. VASCULAR ANATOMYVASCULAR ANATOMY 36. At T3 LevelAt T3 Level 37. At T4 LevelAt T4 Level 38. At T5 LevelAt T5 Level 39

Anterior mediastinal masses account for 50% of all mediastinal masses [1,2]. Anterior mediastinal masses can represent a wide spectrum of diseases, including thymoma, thymic carcinoma, thymic cyst, thymic hyperplasia, mature teratoma, malignant germ cell tumor, and malignant lymphoma [1,3]. CT and mag-neti Mediastinal Teratoma. Enhanced CT scan of the chest shows large, septated anterior. Mediastinal Teratoma. A large anterior mediastinal mass (white arrows) is seen on this contrast-enhanced CT of the chest. The mass contains low density fat (black arrows) and calcifications (green arrows) consistent with a teratoma

Posterior mediastinal mass. A large round area of increased density indicates the presence of a soft tissue mass in the region of the left hilum. The left heart border (adjacent to the anterior mediastinum) remains well defined. Vessels of the left hilum area - including the left pulmonary artery (middle mediastinum) - also remain well defined Imaging evaluation of the mediastinum using a compartmental approach. A compartmental approach has been used for simplifying the evaluation of mediastinal masses in children and adults. 1-6 There are various methods of dividing the mediastinum into compartments by radiologists, pathologists, anatomists and surgeons Thymic cysts are found in 3% of identified anterior mediastinal masses. . Thymoma: Accounts for 20% of all mediastinal tumors and 50% of anterior mediastinal masses. The overall incidence is 0.15 cases per 100,000. The peak incidence is found in the fourth to sixth decades of life and equally in both genders.

Mediastinal Masses in Children : American Journal of

Pediatric Mediastinal Masses: Computed tomography (CT) is the imaging modality of choice for evaluating mediastinal masses detected by radiography or clinical presentation. However, CT results can often be indeterminate. Thoracic magnetic resonance (MR) imaging is a noninvasive way to characterize mediastinal lesions, site of origin, and. Abstract. Anterior mediastinal neoplasms comprise a diverse group of tumors and occasionally manifest as a cystic lesion. We retrospectively reviewed computed tomography (CT) scans in 46 patients with pathologically proved cystic anterior mediastinal tumors. We categorize them into a pure cystic mass and a cystic tumor with a solid portion Mediastinal Masses Nature and Scope of the Problem. Henschke et al reported a prevalence of prevascular (or anterior mediastinal) masses of 0.4% in 9,263 high-risk smokers over the age of 40 who were evaluated as part of the Early Lung Cancer Action Project ; masses <3 cm i In children, tumors are commonly found in the posterior (back) mediastinum. These mediastinal tumors often begin in the nerves and are typically not cancerous. In adults, most mediastinal tumors occur in the anterior (front) mediastinum and are generally malignant (cancerous) lymphomas or thymomas. Is a mediastinal tumor serious

Cases with an anterior mediastinal mass as a result of the first review were further evaluated by two board-certified radiologists with expertise in thoracic imaging (M.N. and H.H.) for the following qualitative findings: (1) shape (round, oval, triangular, irregular), (2) contour (smooth, lobular, irregular), (3) location (midline, right-sided. Basic approach to mediastinal masse Mediastinal Teratoma. Contrast-enhanced axial CT scan of the chest demonstrates an anterior mediastinal mass containing calcification (black arrow), fat (white arrow) and soft tissue components (dotted white arrow). For this same photo without the arrows, click here For more information, click on the link if you see this ico Superior mediastinal mass - Lymphoma. A soft tissue mass widens the superior mediastinum. The mass blends in with the upper edge of the aortic knuckle and obscures the right paratracheal stripe. This mass was found to be lymphoma following lymph node biopsy. Bilateral effusions are also present. « Previous

Abstract: Perioperative management of patients with an anterior mediastinal mass is difficult. We present a 35-year-old woman who showed delayed compression of the carina and left main bronchus despite no preoperative respiratory signs, symptoms, or radiologic findings due to an anterior mediastinal mass and uneventful stepwise induction of general anesthesia Objective: To retrospectively evaluate the safety, diagnostic yield, and risk factors of diagnostic failure of computed tomography (CT) fluoroscopy-guided biopsies of anterior mediastinal masses. Materials and methods: Biopsy procedures and results of anterior mediastinal masses in 71 patients (32 women/39 men; mean [±standard deviation] age, 53.8±20.0years; range, 14-88years) were analyzed Abstract. Radiology V. Holub, MD #{149} Gordon L. Weisbrod, MD, FRCPC Anterior Utility Mediastinal ofTransthoracic Masses: Needle Biopsyâ benign (n The results of 143 transthoracic fleedle biopsies (TNBs) in 126 patients with anterior mediastinal masses were compared with the final diagnosis, which was proved with pathologic study (n = 95) or clinicoradiologic methods (n = 31)

Anterior Mediastinal Mass: A Rare Presentation of Tuberculosis. Gopi C. Khilnani,1 Neetu Jain,1 Vijay Hadda,1 and Sudheer K. Arava2. 1Department of Medicine, All India Institute of Medical Sciences, New Delhi 110 028, India. 2Department of Pathology, All India Institute of Medical Sciences, New Delhi 110 028, India. Academic Editor: Peter Leggat COMPUTED TOMOGRAPHY OF ANTERIOR MEDIASTINAL TUMORS 397 a b a b Fig. 4. Benign cystic teratoma. a) At CT, the tumor (T) has a homogeneous low density with a thick wall (15 HU). A globular cacification is observed in the tumor (+). b) The cut surface of the tumor shows a cyst with a thick wall, and the calcification recognized at CT (+). Fig. 5 Ectopic thyroid tissue (ETT) is a rare entity and a challenging differential diagnosis. This is a report of a case of a mediastinal mass that was found to be an ectopic mediastinal thyroid tissue, in a 77-year-old woman who was admitted to our hospital for breast cancer management. The mediastinal mass was identified in the postsurgical computed tomography (CT) scan of the chest and was. Pera Radiology. This compartment contains fat, ascending aorta, lymph nodes, internal mammary artery and vein, adjacent osseous structures (ribs and sternum), thymus. Therefore will most likely see masses typical to these structures, ie a lymphoma in lymph nodes. Nice work The chest x-ray showed an anterior mass, best seen on the lateral view (fig 1). Afterwards a contrast enhanced CT of the thorax was performed (fig 2-4). A homogeneous, rounded structure was seen in the anterior-superior mediastinum in close relation to the heart and large vessels. In the periphery some calcification was present

Features of anterior mediastinal masses in imaging studies can sometimes be essentially pathognomonic, but are more often only suggestive of a particular diagnosis by themselves; details are discussed in Approaching the Patient with an Anterior Mediastinal Mass: A Guide for Radiologists. 10 CT is the recommended imaging modality for the. An anterior mediastinal mass Section. Chest imaging . Case Type. Clinical Cases Authors. S Capelle 1, D Van Raemdonck 2, J Coolen 1, J Verschakelen 1, W De Wever 1 1 University Hospitals Leuven, Radiology Department, Belgium 2 University Hospitals Leuven, Thoracic Surgery Department, Belgiu

A 24-year-old man who presented with hoarseness of voice was found to have left vocal cord palsy on laryngoscopic examination done outside. Investigations elsewhere also revealed the presence of an anterior mediastinal mass in a noncontrast-computed tomography (CT), and the patient was referred to the thoracic surgery department for surgery An anterior mediastinal mass may be asymptomatic and incidentally discovered on imaging examinations. It could origin compression or local invasion of nerves trunks (causing hoarseness pain, paralysis of the diaphragm or vocal cords), vascular structures (causing superior vena cava syndrome), airways (causing dyspnea, cough), esophagus (causing dysphagia), and bone [] Table 41-2 is an extensive list of the pathologies that can appear as a mass in the anterior mediastinal compartment. By far, the four most common are thymoma, lymphoma, teratoma, and germ cell tumor. Table 41-2 Mass Lesion in the Anterior Mediastinal Compartment: Differential Diagnosi Kitami A, Sano F, Ohashi S, et al. The Usefulness of Positron-Emission Tomography Findings in the Management of Anterior Mediastinal Tumors. Ann Thorac Cardiovasc Surg 2017; 23:26. Gawande RS, Khurana A, Messing S, et al. Differentiation of normal thymus from anterior mediastinal lymphoma and lymphoma recurrence at pediatric PET/CT

Etiology. The anterior mediastinum contains thymus, fat, and lymph nodes, which corresponds with the most common etiologies of associated primary tumors. Although two-thirds of mediastinal masses are benign, about 59% of masses in the anterior compartment are malignant. [1] Most anterior mediastinal masses are epithelial tumors Given the size and location of this well-circumscribed, partially calcified anterior mediastinal mass, a teratoma is among the leading differential diagnoses. Although teratomas are heterogeneous and contain calcification in 53% of cases, cystic changes and fat attenuation are seen in 88% and 76% of tumors, respectively, and both were lacking.

Answer: A. Chest pain. About two thirds (62%) of patients with mediastinal masses of any etiology will have symptoms at the time of diagnosis 2. Chest pain is the most frequently reported symptom (30%) followed by fever and chills (20%) 2. Anterior mediastinal masses produce symptoms at a greater frequency (75%) than masses from middle or. Radiology Pearls Tuesday, March 27, 2012. Anterior mediastinal masses Click diagram to enlarge-If the patient does not have history of lymphoma, we report that the mass seen in the anterior mediastinum is thymoma after exclusion of the retrosternal goiter

Anterior mediastinal masses account for 50% of all mediastinal lesions. The classic differential diagnosis for masses in the anterior mediastinum includes lymphadenopathy, thymoma, teratoma, and a thyroid goiter extending from the neck into the mediastinum. An anterior mediastinal mass may rarely be caused by ectopic thyroid tissue Here is a mnemonic from category Radiology named Anterior mediastinal masses: - 4 T's: Teratoma Thymoma Testicular-type T-cell / Hodgkin's lymphom

Imaging of Cystic Masses of the Mediastinum RadioGraphic

CT evaluation of the anterior mediastinum: spectrum of

The 5 T's of Anterior Mediastinal Masses RADIOLOGYPICS

Mediastinal Masses Radiology Ke

Radiology In Ped Emerg Med, Vol 7, Case 12The Radiology Assistant : Pediatric Chest CT 1

Anterior mediastinal mass - lymphoma Radiology Case

Posterior chamber. This is a very small area posterior to the iris, which we cannot discern on imaging. Specific pathologies in this area are: glaucoma, uveitis and ciliary melanoma. Vitreous body. The larger area posterior to the lens is the vitreous body. Specific pathologies within the vitreous body are: Rupture Germ cell: A rare mediastinal mass is a germ cell a tumor. They are very rare. They are usually benign (60 to 70%) and are found in both males and females. Thyroid mass: substernal goiter remains a significant consideration in the differential diagnosis of mediastinal masses, particularly those located in the anterior mediastinum. Substernal. FDG PET/CT study revealed a 13-cm by 9-cm left anterior mediastinal mass demonstrating intense circumferential FDG activity, with maximum standard uptake value (SUV max) of 13.4, and central low. mediastinal masses. hilum and Radiology needle biopsy of J Thorac Imaging mediastinum. 1987; 2:41-48. Gobien RP, Skucas J, Paris BS. CT-assisted fluoroscopically guided aspiration biopsy of central hular and mediastinal masses. Radiology 1981; 141:443-447 The differential diagnosis of mediastinal lesions includes a wide variety of neoplastic, congenital, vascular, and lymphatic etiology [].The location and composition of the mediastinal lesions are essential to limit the diagnostic possibilities [].Computed tomography (CT) is considered the primary modality of choice for morphological evaluation of mediastinal tumors