MEDIASTINAL MASS / WIDENED MEDIASTINUM ON CXR

lymph nodes (usually in middle and superior mediastinum):

tuberculosis

sarcoidosis

metastases

lymphomas / leukaemias

thymus (anterior mediastinum):

thymoma (benign / malignant)

thymic cyst

thyroid (anterior mediastinum):

tumours

retrosternal goitre

cardiovascular:

aneurysms:

aortic arch

innominate artery

cardiac

carotids (at origin)

cardiac tumours

pericardial fat pad (anterior mediastinum)

oesophageal (posterior mediastinum):

tumours

hiatus hernia

achalasia

abscess (following perforation)

developmental abnormalities:

enterogenous cyst (posterior mediastinum)

anterior thoracic meningocoele (posterior mediastinum)

bronchogenic cyst (middle mediastinum)

other tumours:

teratoma (anterior mediastinum):

benign (dermoid cyst)

malignant

posterior mediastinum:

neurofibroma ('dumb-bell' tumour)

neuroblastoma / ganglioneuroma

other causes:

scoliosis

pleuro-pericardial cyst (anterior mediastinum)

any lung mass close to mediastinum

diaphragmatic hernia

sternal tumours

mediastinal haemorrhage

pneumomediastinum

paravertebral masses (posterior mediastinum):

abscess

myeloma

metastases

lymphoma

NB: anterior mediastinum is usually empty; commonest masses here are:

retrosternal goitre

thymoma

lymph nodes

 

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