A pictorial review of unusual thoracic masses

Congress:

ESTI 2015

Poster Number:

P-0004

Type:

Educational Poster

Keywords:

MR, PET, CT, Thorax, Mediastinum, Computer Applications-Detection, diagnosis, Biopsy, Education and training

Authors:

S. Singh, S. Karthik, A. L. Johnstone, M. Darby; Leeds/UK

DOI:

10.1594/esti2015/P-0004

DOI-Link:

https://dx.doi.org/10.1594/esti2015/P-0004

Fig. 1: Widening of superior mediastinum

Fig. 2: Posterior meditational mass

$Fig. 3: Wedge fractures of thoracic vertebral bodies$

Fig. 3: Wedge fractures of thoracic vertebral bodies

Fig. 4: Post Treatment Scan

Learning objectives

In this pictorial review, we illustrate the imaging features on computer tomography (CT) of uncommon benign and malignant non-pulmonary non-cardiac masses. We focus on the role of CT and CT guided biopsies in the evaluation and diagnosis of these entities.

Background

Finding an opacity on a chest radiograph (CXR) is a source of anxiety for the patient. Most individuals worry about lung cancer which is one of the commonest cancers and is associated with a poor 5-year survival. Whilst lung cancer and other malignancies such as lymphomas and thymic/cardiac tumours remain major concerns, not infrequently, more unusual tumours are found during the course of investigating these opacities.

Imaging findings OR Procedure details

We present a review of imaging features and role of imaging and radiologist in the diagnostic pathway of these unusual tumours. For the purpose of this review, we will focus on unusual masses in the mediastinum and chest wall/pleura. Some of the following are reviewed in this pictorial review. 1. Mediastinal Lesions: (1) Dermoids and teratomas; (2) Duplication Cysts; (3) Unusual thymic tumours (4) Tracheal tumours (5) Non-neural posterior mediastinal masses 2. Benign and malignant pleural/chest wall tumours including sarcomas and bone lesions. We will...

Conclusion

Although these lesions are rare in themselves, they are encountered not too infrequently in our large tertiary centre MDT. Such cases pose a diagnostic and therapeutic challenge, in part, due to their relative low incidence. Although there is frequent overlap in the CT appearance of many of these lesions, some have characteristic imaging features that can suggest a specific diagnosis. PET CT is useful to rule out the metastatic disease in malignancy. MRI has limited role in thoracic wall lesions although its usefulness in characterisation...

References

Laird R C. Intrathoracic Tumours. Can Med Assoc J 1951 Mar; 64(3): 244–248. Cancer Research UK Cancer Survival Group, London School of Hygiene and Tropical Medicine. Personal communication, 2014. Case 1 Masood A, Hudhud KH, Hegazi A, Syed G. Mediastinal plasmacytoma with multiple myeloma presenting as a diagnostic dilemma.Cases Journal. 2008;1:116. Rao MG, Venkatesh R. Radiological evaluation of extramedullary plasmacytoma.Kans Med.1994;95:94–5 Sung Y L.,Je H K,Jae S S, Chol S.,Kwang H.,Kyung H K, Se H Y. A Case of Extramedullary Plasmacytoma Arising from the Posterior...

Personal Information

Dr. S. Singh (Specialist Registrar Radiology), Leeds Teaching Hospital NHS Trust, Leeds, UK. Dr. S. Karthik (Consultant Radiologist), Leeds Teaching Hospital NHS Trust, Leeds, UK. Dr. A. Johnstone (Consultant Radiologist), Leeds Teaching Hospital NHS Trust, Leeds, UK. Dr. M. Darby (Consultant Radiologist), Leeds Teaching Hospital NHS Trust, Leeds, UK.