mediastinum


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  • Anterior (substernal space)

    • lymphoma (monomorphic CD3/20, RS cells)
    • GCT (AFP, hCG, PLAP, testicular mass)
    • thymus
      • normal (T with maturation)
        • Cortex
          • outer cortex: blastic cells,
          • inner cortex: mature lymphs
          • occasional apoptosis
          • precursor T cells
        • Medullary and perivascular spaces
          • mature lymphs
          • asteroid cells
        • Immunophenotype
          • precursor T cells: TdT, CD1a, CD4, CD8
          • mature T cells: TdT-, CD1a-, CD3+, CD4/CD8 single positive
          • asteroid cells: CD23, CD37, CD72, CD76, IgM, IgD
      • thymoma (CD99, MG)
      • thymic carcinoma (variable CD117, 5, CK)
      • cyst
    • thyroid, parathyroid (uptake scans)
    • soft tissue

  • Mid (heart, esophagus)

    • cyst (bronchogenic, pericardial, esophageal)
    • lymphadenopathy (lymphoma, sarcoid, metastasis)
    • esophageal, cardiovascular

  • Posterior

    • neurogenic
      • spindle (neurosarcoma, ganglioneuroma, neurofibroma, neurilemmoma)
      • round: (ganglio)neuroblastoma, chemodectoma, pheochromocytoma)
    • meningocele, spinal lesion
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