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November 11, 1974

Middle Mediastinal Lesion

Author Affiliations

From the Division of Diagnostic Radiologic Pathology, Armed Forces Institute of Pathology (LCDR Reed), and the Department of Radiology, Walter Reed Army Medical Center (COL Reeder), Washington, DC.

JAMA. 1974;230(6):891-892. doi:10.1001/jama.1974.03240060061040

  1. Aneurysm of aorta or major arteries; right aortic arch

  2. Azygos vein enlargement

  3. Bronchogenic cyst

  4. Esophageal lesion (eg, leiomyoma, carcinoma, achalasia, varices)

  5. Hiatal hernia

  6. Lymph node enlargement

  7. Thyroid tumor

  1. Chemodectoma

  2. Enteric cyst

  3. Hematoma

  4. Sclerosing inflammatory mass; mediastinal abscess or fibrosis

  5. Mesenchymal tumor

  6. Pancreatic pseudocyst

  7. Parathyroid tumor

  8. Tracheal tumor or cyst

  9. Vagus or phrenic neurinoma

Diagnosis  Bronchogenic cyst.

Comment  In analyzing the gamut of this case, the retrocardiac position of the mediastinal mass is especially helpful, since this location effectively excludes such possibilities as large azygos vein, thyroid tumor, tracheal tumor or cyst, and parathyroid tumor. Lymph node enlargement is the most common cause of a middle mediastinal mass, but enlarged mediastinal nodes will usually be found around the carina tracheae or in the paratracheal area and are frequently accompanied by a more generalized adenopathy, including the parahilar nodes. Hiatal hernia occurs in the retrocardiac area