Lymphoma - mediastinal

Alternative names

Thymoma - mediastinal; Mediastinal tumor

Definition

Mediastinal tumors form in the cavity that separates the lungs. This cavity contains the heart, large blood vessels, trachea, thymus, and connective tissues.

Causes, incidence, and risk factors

The mediastinum is the part of the chest between the sternum and the spinal column. It contains the esophagus, trachea, heart, and other important structures. The mediastinum is divided into three sections:

• The anterior (front)
  
• The middle
  
• The posterior (back)
  

Overall, mediastinal tumors are rare.

The most common location for tumors within the mediastinum varies according to the age of the patient. In children, tumors are more common in the posterior mediastinum. These often begin in the nerves and are often benign.

In contrast, most mediastinal tumors in adults occur in the anterior mediastinum and are usually malignant (cancerous) lymphomas or thymomas. These occur most commonly in people aged 30-50.

Symptoms

Almost half of mediastinal tumors cause no symptoms and are discovered on a chest x-ray performed for another reason. When present, symptoms are related to compression of local structures and may include:

• Cough
  
• Shortness of breath
  
• Chest pain
  
• Fever
  
• Chills
  
• Night sweats
  
• Coughing up blood (hemoptysis)
  
• Hoarseness
  

Signs and tests

Mediastinal tumors are first suspected during history and physical examination which may reveal:

• Fever
  
• Unintentional weight loss
  
• Lymphadenopathy (swollen or tender lymph nodes)
  
• Wheezing
  
• Stridor
  

Further diagnostic evaluation typically includes:

• Chest x-ray
  
• CT scan of the chest
  
• MRI of the chest
  
• CT-guided needle biopsy