| What are mediastinal tumors? | . |
| What are main mediastinal tumors? | Thymoma (invasive or not), Lymphoma: Hodgkin, Cystic hygroma: lymphangioma Mediastinal goiter, Teratoma (mature), Germinal tumor, Epithelioid haemangioendothelioma, Sarcoidosis: hilar lymph node, Schwannoma, Neurogenic tumors.
IMPORTANT mediastinum is best seen by CT |
| What are thymic tumors in epithelium? | • Benign
Encapsulated thymoma
• Malignant
Invasive thymoma
Epithelial
Lymphocytic
Mixed lymphocytic and epithelial
• Thymic carcinoma
Squamous cell carcinoma
Lymphoepithelioma-like carcinoma
Basaloid carcinoma
Mucoepidermoid carcinoma
Sarcomatoid carcinoma
Mixed small cell/undifferentiated/squamous cell carcinoma |
| What are histologic classifications of thymomas? | • Type A thymoma (medullary) - benign
• Type AB thymoma (mixed) - bening
• Type B thymoma:
Type B1 (organoid)
Type B2 (cortical)
Type B3 (epithelial) - malignant
• Type C (thymic carcinoma) - malignant |
| Clinical Disorders Associated with Thymomas | Myasthenia gravis (dx by anti Ach Ab)
we have neuromuscular syndromes, Hematologic syndromes, Collagen diseases, dermatologic, endocrine, renal, bone, malignancy |
| What are germ cell tumors of thymus? | • Seminoma
• Teratoma:
Benign cystic teratoma
Immature teratoma
Malignant teratoma
• Embryonal carcinoma
• Endodermal sinus tumor (yolk sack tumor)
• Choriocarcinoma
• Combined germ cell tumors |
| What are other types of thymic tumors? | • Tumors of lymphoid origin:
Malignant lymphoma
Hodgkin's disease
Non-Hodgkin's lymphomas (lymphoblastic, others)
• Tumors of neuroendocrine cell origin:
Carcinoid
Oat cell carcinoma
• Tumors of adipose tissue:
Thymolipoma
• Metastatic tumors of the thymus |
| How is management of anterior mediastinus tumors? | . |
| How is management of epithelial mediastinal tumors? | . |
| How is Masoaka postop staging of thymic tumors management? | . |
| What is indication for mediastinoscopy? | • Typing of tumors:
- mediastinal tumors if accessible for histological
typing (thymoma, lymphoma, thyroid goiter or
neoplasm, etc).
- lung cancer: if bronchoscopy is non
contributive,
• Diagnosis of inflammatory diseases:
- sarcoidosis (biopsy of mediastinal lymph
nodes) |
| What are complications of mediastinoscopy? | • Hemorrhage (innominate vein or aorta).
• Tracheal or bronchial lacerations.
• Esophageal lacerations.
• Recurrent nerve lesion (sectioned or electrocoagulated).
• Pneumothorax.
• Skin infection. |
| What are thoracoscopic surgeries done in mediastinal diseases? | Resection of thymomas, Neurogenic tumors, Mini-Sternotomy: Goiter, Sternotomy: Melanoma |
| What are mediastinal infections? | Tuberculosis, Mediastinitis |
| What are classifications of mediastinal infections? | . |
| How is tx of mediastinal infections?? | . |
| How is surgical tx of mediastinal infections? | . |
