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The clinical and histological diagnosis of mediastinal tumors has to be completed with an appreciation of the biological relationship between the tumor and its host. This is most important for neurogenic and thymic tumors. Successful removal is sometimes possible even after a long time of observation. Auxillary use of radiation and cystostatics is recommended.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Mediastinal masses are commonly classified into lesions of the anterior, middle, and posterior compartment as a first step in differential diagnosis. Teratoma, neurogenic tumors, goiters, and thymoma with their characteristic localization constitute together already two thirds of all mediastinal neoplasms. However, the differential diagnosis of mediastinal masses should include also rare diseases: lymphangio-hemangioma, aneurysm of the pulmonal artery, intrathoracic meningocele, esophageal cyst, and pleurobronchial cyst are demonstrated. It is emphasized, that differential diagnosis has to consider history and physical data of the patient as well.
An analysis of 252 patients with benign tumore and cysts of the mediastinum indicated that high per cent (35%) of diagnostic errors is conditioned by the absence of clinical signs typical for this pathology, as well as rather similar roentgenological symptomatics in its different forms. Following resection of large neoplasms, when it proved unfeasible to close the pleural defect (the removed tumor bed) by suturing its margins, the aughors performed alloplasty with lyophilized pericardium or dura mater. Pleural alloplasty was employed in 18 (8.7%) patients. In all 206 operated patients no significant postoperative complications were observed. There were no lethal issues. Ii is felt that plastic repair of pleural defects should be considered absolutely essential while removing benign mediastinal neoplasms.
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Four cases of the superior vena caval obstruction caused by mediastinal tumor and fibrous mediastinitis are presented. Palliation was achieved by resection of tumor or scar tissue and placing a Teflon or autogenous vein patch to the resected defect of the superior vena cava. One of the patients died of metastasis at 8 months postoperatively, but patency of the patch graft was confirmed. The other three are alive and well at 14, 14 and 11 years, respectively. Continued patency has been confirmed by venographies in two of them.
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Neural crest cells are unique. Few tissues found in the embryo are expressed with such diversity in adults. Cellular differentiation occurs simultaneously with widespread migration. Neural crest cell neoplasia results in some of the most common tumors clinically encountered. As a group, these tumors are called neurolophomas. This report describes the neural crest formation, the tissues normally derived from it, a classification of the neural crest tumors, and a review of such tumors as they arise in the thorax.
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Clinical examinations with the whole body CT scanner require considerable individualization of examination technique in relation to specific organs, anatomic areas, and clinical problems. Careful selection of radiographic factors, patient position, contrast agents, and pharmacologic adjuncts will optimize diagnostic results and patient throughput.
Isolated increased uptake of 99mTc-sulfur colloid in a static liver scan with associated hepatic scintiangiography demonstration of collateral venous circulation is pathognomonic for superior vena caval obstruction. A case with these findings is reported and the differential diagnosis of "hot spots" occurring in liver scanning is discussed.