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{{CMG}} {{AE}} {{Trusha}}
{{CMG}} {{AE}} {{Trusha}}


# [[Endometriosis|Bowel endometriosis]] vs [[Hemorrhoids]] vs [[Diverticular disease|Diverticular diseases]] vs [[Anal fissure]] vs [[Ulcerative colitis]] vs [[Crohn's disease]]
==new==
# Colorectal carcinoma ([[Adenocarcinoma]]) vs [[Peutz-Jeghers syndrome]] vs [[Juvenile polyposis syndrome|Juvenile Polyposis Coli]] vs [[Gastrointestinal stromal tumor|Gastrointestinal Stromal Tumors]] vs [[Hamartoma]] vs [[MALT lymphoma|Colorectal Lymphoma]]
 
# [[Strangulated hernia]] vs [[Appendicitis]] vs [[Crohn's disease]]
 
# [[Irritable bowel syndrome]] vs [[Crohn's disease]] vs [[Ulcerative colitis]] vs [[Infectious colitis]] vs [[Carcinoid|Carcinoids]]
 
{| align="right"
|
[[Image:Squamous cell mircopathology2.jpeg|x200px|thumb| Micropathology: Squamous cell carcinoma of the lung. H&E stain, By Nephron [https://commons.wikimedia.org/wiki/File%3ALung_squamous_carcinoma_--_high_mag.jpg Wikimedia Commons]]]
|}
{| align="right"
|
[[Image:Bronchial cancer.jpeg|x200px|thumb|Gross pathology: Bronchial squamous lung cell cancer By John Hayman [Public domain], (Image source: [https://commons.wikimedia.org/wiki/File%3ACa_bronchus.jpg Wikimedia Commons])]]
|}


{|
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Diseases
| colspan="5" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Clinical manifestations'''
! colspan="5" rowspan="2" |Para-clinical findings
| colspan="1" rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Gold standard'''
! rowspan="4" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Additional findings
|-
| colspan="4" rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |'''Symptoms'''
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Physical exam
|-
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Lab Findings
! colspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Radiology
! rowspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Histopathology
|-
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Productive cough
! colspan="1" rowspan="1" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Hemoptysis
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Weight loss
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Auscultation
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sputum analysis
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nodule
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Nodule content
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Other findings
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pulmonary nodule|Pulmonary Nodule]](benign)
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* Asymptomatic
| style="background: #F5F5F5; padding: 5px;" |
* Normal


* [[pleural friction rub]]
* [[egophony]]
* [[Rales|Crackling]] or bubbling
* [[Whispered pectoriloquy]]
* Absent [[breath sounds]]
| style="background: #F5F5F5; padding: 5px;" |Normal
| style="background: #F5F5F5; padding: 5px;" |
* Single
* Round, oval
* <5 mm [[Nodule (medicine)|nodule]]
* [[Ground glass opacification on CT|Ground glass]]
| style="background: #F5F5F5; padding: 5px;" |[[Fat]]


[[Calcification]]
# [[Superior vena cava obstruction]]
# [[Partial anomalous pulmonary venous connection]]
# [[Esophageal achalasia]]
# [[Esophageal cancer]]
# [[Esophageal rupture]]
# [[Hiatus hernia]]
# [[Hilar lymphadenopathy]]
# [[Pneumomediastinum]]
# [[Sarcoidosis]]
# [[Lymphoma]]
# [[Neurilemmoma]]
# [[Non-Hodgkin lymphoma]]
# [[Teratoma]]
# [[Thymoma]]
 
# [[Thyroid cancer]]
# [[Goitre]]
# [[Mediastinal germ cell tumor]],
# [[Mediastinal tumor]],
# [[Mediastinitis]]
 
# [[Churg-Strauss syndrome]]
# [[Bronchogenic cyst]],
# [[Dermoid cyst]]
# [[Anthrax]]:
# [[Tularemia]]
 
 
[[File:Mediastinal lymohangioma GIF.gif|x200px|thumb| CT scan shows cystic mass which was located on the posterior to the lower esophagus later diagnosed as thoracic duct lymphangioma. [https://doi.org/10.5090/kjtcs.2014.47.4.423 Source:Case courtesy of Jin San Bok et al, Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital]]]
 
[[File:Posterior-mediastinal-schwannoma.gif|x200px|thumb| CT scan showing a soft tissue density lesion within the left posterior mediastinum, in a paravertebral location. The lesion is closely related to the left neural exit foramen, but there is no definite extension into the spinal canal. The lesion does extend into the intercostal space.
Case courtesy of Dr Paul Leong
(Picture courtesy:[https://radiopaedia.org/cases/26625 Radiopedia])]]


Types:
* Central dense [[nidus]]
* Diffuse solid
* Laminated
* Popcorn
| style="background: #F5F5F5; padding: 5px;" |
* well-defined smooth border
* Growth rate > 18 months
* Cavity wall thickness of 1 mm
| style="background: #F5F5F5; padding: 5px;" |
* N/A
| style="background: #F5F5F5; padding: 5px;" |N/A
| style="background: #F5F5F5; padding: 5px;" |[[Oxygen saturation|↓ O2 Sat]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lung cancer|Pulmonary Nodule (malignant)]]
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" |
* [[Dyspnea]]
* Non resolving [[pneumonia]]
* [[Wheeze|Wheezing]]
* [[Chest pain]]
* [[Cachexia]]
* [[Fatigue]]
* [[Anorexia|Loss of appetite]]
* [[Dysphonia]]
* [[Dysphagia]]
| style="background: #F5F5F5; padding: 5px;" |
* Normal


* [[pleural friction rub]]
* [[egophony]]
* [[Rales|Crackling]] or bubbling
* [[Whispered pectoriloquy]]
* Absent [[breath sounds]]
| style="background: #F5F5F5; padding: 5px;" |[[Cancer|Tumor cells]]
| style="background: #F5F5F5; padding: 5px;" |
* Single or multiple
* Small or > 2 cm of size
| style="background: #F5F5F5; padding: 5px;" |[[Calcification]]
* Amorphous
* Punctate
* Reticular
* Stippled or eccentric
[[Cavity]]


[[Ulcer|Ulceration]]
*
| style="background: #F5F5F5; padding: 5px;" |
* Spiculated border
* Rapid growth rate (Doubling time 1-18 months)
* [[Cavity]] wall thickness over 15 mm
| style="background: #F5F5F5; padding: 5px;" |
* Central [[necrosis]] 
* [[Cavity]] lined by viable [[cancer cells]] without [[necrosis]] 
* 
| style="background: #F5F5F5; padding: 5px;" |[[Biopsy]] and [[histopathology]]
| style="background: #F5F5F5; padding: 5px;" |[[Oxygen saturation|↓ O2 Sat]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
*
| style="background: #F5F5F5; padding: 5px;" |
*
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Diseases
! colspan="1" rowspan="1" |Productive cough
! colspan="1" rowspan="1" |Hemoptysis
!Weight loss
!Other symptoms
!Auscultation
!Sputum analysis
!Nodule
!Content
!Other findings
!Histopathology
|'''Gold standard'''
!Additional findings
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lung abscess|Abscess]]
<ref name="pmid26366400">{{cite journal |vauthors=Kuhajda I, Zarogoulidis K, Tsirgogianni K, Tsavlis D, Kioumis I, Kosmidis C, Tsakiridis K, Mpakas A, Zarogoulidis P, Zissimopoulos A, Baloukas D, Kuhajda D |title=Lung abscess-etiology, diagnostic and treatment options |journal=Ann Transl Med |volume=3 |issue=13 |pages=183 |date=August 2015 |pmid=26366400 |pmc=4543327 |doi=10.3978/j.issn.2305-5839.2015.07.08 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* High [[fever]]
(> 101' F)
* [[Pleuritic chest pain|Pleuritic]] [[chest pain]]
* [[Sputum|Foul smelling sputum]]
* [[Sleep hyperhidrosis|Night sweats]]
* [[Dyspnea]]
* [[Fatigue]]
| style="background: #F5F5F5; padding: 5px;" |
* Decreased [[Breath sounds|breath sound]]
* Bronchial [[Breath sounds|breath sound]]
* [[Crackles|Inspiratory crackles]]
* [[Crepitations|Localised crepitations]]
| style="background: #F5F5F5; padding: 5px;" |[[Microorganism|Causative agents]]
| style="background: #F5F5F5; padding: 5px;" |
* Vary in size
* Round in shape


*
__NOTOC__
| style="background: #F5F5F5; padding: 5px;" |
{{SI}}
* [[Fluid/gas-fluid level]]
{{CMG}}; {{AE}} {{Trusha}}, {{AM}}
* Surrounding area [[Consolidation (medicine)|consolidation]]
* [[Cavity]] persists longer than [[Consolidation (medicine)|consolidation]]
| style="background: #F5F5F5; padding: 5px;" |.
* The wall of the [[abscess]] is typically thick and the [[luminal]] surface irregular
* [[Bronchial vessels|Bronchial vessels and]] [[Bronchus|bronchi]] are truncated
| style="background: #F5F5F5; padding: 5px;" |
* Centrally, [[Necrosis|necrotic tissue]] mixed with [[Necrosis|necrotic granulocytes]] and [[bacteria]]
* [[Neutropenia|Neutrophilic]] [[Granulocyte|granulocytes]] with [[Dilation|dilated]] [[Blood vessel|blood vessels]]
* [[Inflammation|Inflammatory]] [[Edema|oedema]]
| style="background: #F5F5F5; padding: 5px;" |[[Histopathology]]
| style="background: #F5F5F5; padding: 5px;" |[[Clubbing|Clubbing of finger]]
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Septic emboli|Septic pulmonary]]
[[Septic emboli|emboli]]


<ref name="pmid21686732">{{cite journal |vauthors=Chang E, Lee KH, Yang KY, Lee YC, Perng RP |title=Septic pulmonary embolism associated with a peri-proctal abscess in an immunocompetent host |journal=BMJ Case Rep |volume=2009 |issue= |pages= |date=2009 |pmid=21686732 |pmc=3029652 |doi=10.1136/bcr.07.2008.0592 |url=}}</ref>
{{SK}} Mediastinal enlargement; mass in the mediastinum
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* High [[fever]]
* [[Dyspnea]]
* [[Chest pain]]
* Focus of primary infection (Most common, right heart [[endocarditis]])
| style="background: #F5F5F5; padding: 5px;" |
* [[S2|Prominent P2 component of second heart sound]]
* Decreased [[Breath sounds|breath sound]]
* [[Rales]]
* [[Crackles]]
* [[Pleural friction rub]]
| style="background: #F5F5F5; padding: 5px;" |N/A
| style="background: #F5F5F5; padding: 5px;" |
* Multiple peripheral [[Nodule (medicine)|nodules]]
* Size 0.5– 3.5 cm
* Variable shapes
| style="background: #F5F5F5; padding: 5px;" |
* Central low attenuation
* Feeding [[Blood vessel|vessels]]
* Pleura based wedge-shaped lesions
| style="background: #F5F5F5; padding: 5px;" |
* Air bronchogram
* [[Abscess]] or infection related changes at the primary focus
| style="background: #F5F5F5; padding: 5px;" |
* N/A
| style="background: #F5F5F5; padding: 5px;" |[[Culture media|Culture]] and [[Sensitivity (tests)|sensitivity]]
| style="background: #F5F5F5; padding: 5px;" |N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mycosis|Fungal]]
[[Mycosis|infection]]


<ref name="ChongLee2006">{{cite journal|last1=Chong|first1=Semin|last2=Lee|first2=Kyung Soo|last3=Yi|first3=Chin A|last4=Chung|first4=Myung Jin|last5=Kim|first5=Tae Sung|last6=Han|first6=Joungho|title=Pulmonary fungal infection: Imaging findings in immunocompetent and immunocompromised patients|journal=European Journal of Radiology|volume=59|issue=3|year=2006|pages=371–383|issn=0720048X|doi=10.1016/j.ejrad.2006.04.017}}</ref>
==Overview==
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[Fever]]
* [[Dyspnea]]
* [[Chest pain]]
* [[Hypersensitivity]] or [[Allergy|allergic reactions]]
* History of travel
| style="background: #F5F5F5; padding: 5px;" |
* Decreased [[Breath sounds|breath sound]]
* [[Rales]]


* [[Crackles]]
The [[mediastinum]] is a non-delineated group of structures in the thorax (chest), surrounded by loose connective tissue. Since it is the central compartment of the thoracic cavity, and it contains a lot of important structures, it is the site of involvement of various tumors.
* [[Pleural friction rub]]
| style="background: #F5F5F5; padding: 5px;" |KOH stain: Fungi
| style="background: #F5F5F5; padding: 5px;" |
* Multiple nodules
* Size 0.5– 3 cm
* nodules surrounded by ground-glass opacity/halo
| style="background: #F5F5F5; padding: 5px;" |
* Cavity
| style="background: #F5F5F5; padding: 5px;" |
* Halo sign in [[aspergillosis]]
* Patchy infiltrate
* Consolidation
* [[Mediastinal lymphadenopathy|Mediastinal adenopathy]]
| style="background: #F5F5F5; padding: 5px;" |
* Specific causative agent
| style="background: #F5F5F5; padding: 5px;" |[[Culture and sensitivity]]
| style="background: #F5F5F5; padding: 5px;" |N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Parasitism|Parasites]]
<ref name="pmid20880867">{{cite journal |vauthors=Kunst H, Mack D, Kon OM, Banerjee AK, Chiodini P, Grant A |title=Parasitic infections of the lung: a guide for the respiratory physician |journal=Thorax |volume=66 |issue=6 |pages=528–36 |date=June 2011 |pmid=20880867 |doi=10.1136/thx.2009.132217 |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" |
* [[Asymptomatic]]
* [[Chest pain]]
* [[Pneumothorax]]
* [[Fever]]
* [[Wheeze]]
* [[Urticaria]]
* Rarely, [[anaphylaxis]]
| style="background: #F5F5F5; padding: 5px;" |
* Decreased [[Breath sounds|breath sound]]
* Rales


* [[Crackles]]
==Causes==
| style="background: #F5F5F5; padding: 5px;" |N/A
| style="background: #F5F5F5; padding: 5px;" |
* [[Cyst|Cysts]]: Single or multiple well-defined homogenous
* [[Pulmonary nodule|Coin lesion]]: 1–3 cm
| style="background: #F5F5F5; padding: 5px;" |[[Cyst]]:
* Fluid or gas
* [[Parasitic worm|Worm]]
[[Pulmonary nodule|Coin lesion]]:
* Central [[Necrosis|necrotic]] area surrounded by [[Granuloma|granulomatous]] reaction and fibrous wall
| style="background: #F5F5F5; padding: 5px;" |
* [[Calcification|Calcified cyst wall]]
* [[Consolidation (medicine)|Consolidation]]
* [[Pleural effusion]]
* [[Parasitic worm|Worm]]
| style="background: #F5F5F5; padding: 5px;" |
* Presence of [[larvae]] or eggs


*
| style="background: #F5F5F5; padding: 5px;" |Visualization of [[Parasites|parasite]], egg or larvae
| style="background: #F5F5F5; padding: 5px;" |N/A
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Diseases
! colspan="1" rowspan="1" |Productive cough
! colspan="1" rowspan="1" |Hemoptysis
!Weight loss
!Other symptoms
!Auscultation
!Sputum analysis
!Nodule
!Content
!Other findings
!Histopathology
|'''Gold standard'''
!Additional findings
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tuberculosis|Mycobacterial infections]]
<ref name="pmid25861338">{{cite journal |vauthors=Ryu YJ |title=Diagnosis of pulmonary tuberculosis: recent advances and diagnostic algorithms |journal=Tuberc Respir Dis (Seoul) |volume=78 |issue=2 |pages=64–71 |date=April 2015 |pmid=25861338 |pmc=4388902 |doi=10.4046/trd.2015.78.2.64 |url=}}</ref><ref name="Mandell">{{cite book | last = Mandell | first = Gerald | title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases | publisher = Churchill Livingstone/Elsevier | location = Philadelphia, PA | year = 2010 | isbn = 0443068399 }}</ref>
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Chronic cough]]
* [[Fever]]
* [[Sleep hyperhidrosis|Night sweats]]
* [[Dyspnea]]
* [[Wheeze|Wheezing]]
* [[Chest pain]]
* [[Cachexia]]
* [[Fatigue]]
* [[Anorexia|Loss of appetite]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Decreased breath sounds]]
* [[Rales]]
* [[Rhonchi]]
* Bronchial breath sounds
| style="background: #F5F5F5; padding: 5px;" |AFB+
| style="background: #F5F5F5; padding: 5px;" |
* Micronodules in the [[subpleural]] region and peribronchovascular interstitium


* Fluffy upper zone shadowing
* [[Cavity]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Superinfected]] [[Cavity|cavities]] shows air-fluid level
| style="background: #F5F5F5; padding: 5px;" |
* Fluffy upper zone shadowing
* Interlobular septal thickening
* Homogeneous and dense [[Consolidation (medicine)|consolidation]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Granuloma|Granulomas]]: [[necrotizing]] or non-necrotizing
* [[Langhans giant cell|Langhans giant cells]]
* [[Caseous necrosis]]
| style="background: #F5F5F5; padding: 5px;" |Culture and sensitivity
| style="background: #F5F5F5; padding: 5px;" |N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Chronic inflammatory conditions
[[Granulomatosis with polyangiitis|(Granulomatosis with polyangiitis)]]


<ref name="pmid27195187">{{cite journal |vauthors=Kubaisi B, Abu Samra K, Foster CS |title=Granulomatosis with polyangiitis (Wegener's disease): An updated review of ocular disease manifestations |journal=Intractable Rare Dis Res |volume=5 |issue=2 |pages=61–9 |date=May 2016 |pmid=27195187 |pmc=4869584 |doi=10.5582/irdr.2016.01014 |url=}}</ref>
==Initial Evaluation==
| style="background: #F5F5F5; padding: 5px;" | +/-
{{familytree/start}}
| style="background: #F5F5F5; padding: 5px;" | +
{{Family tree |border=2|boxstyle=background: WhiteSmoke;| | | | | A01 | | | | |A01=<div style="float: left; text-align: center; height: 1.25em; width: 25em; padding: 1em;">'''Mediastinal Mass'''</div>}}
| style="background: #F5F5F5; padding: 5px;" | -
{{familytree | | | | | |!| | | | | | | | }}
| style="background: #F5F5F5; padding: 5px;" |
{{familytree | | | | | B01 | | | |B01=<div style="float: left; text-align: left; line-height: 150%; padding: 1em; "> '''Workups'''
* [[Hoarseness]]
----
* [[Chest pain]]
❑ CT chest with contrast <br> ❑ Serum beta-HCG, AFP, if appropriate <br> ❑ CBC, platelets <br> ❑ PET-CT scan (optional) <br> ❑ Pulmonary function tests if clinically indicated <br> ❑ MRI chest if clinically indicated
* [[Dyspnea]]
</div>}}
* [[Stridor]]
{{familytree | |,|-|-|-|^|-|-|-|.| | | | | | | }}
| style="background: #F5F5F5; padding: 5px;" |
{{familytree | C01 | | | | | | C02 | | | |C01=<div style="float: left; text-align: center; height: 1.25em; width: 15em; padding: 1em;"> '''Thymic Tumor Likely''' </div> |C02= <div style="float: left; text-align: center; height: 1.25em; width: 15em; padding: 1em;">  '''Thymic Tumor Unlikely''' </div>}}
* [[Pleural friction rub]]
{{familytree | |!| | | | | | | |!| | | | | }}
* Absent breath sound
* [[Crackles]]
| style="background: #F5F5F5; padding: 5px;" |N/A
| style="background: #F5F5F5; padding: 5px;" |
* Multiple round lesions
* Size 0.5 to 10 cm
| style="background: #F5F5F5; padding: 5px;" |
* Patchy or diffuse ground-glass opacities, or both
| style="background: #F5F5F5; padding: 5px;" |
* [[Cavity]]
* Thick wall
* Irregular inner contour
* [[Atelectasis]]
| style="background: #F5F5F5; padding: 5px;" |
* Pathologic triad of [[Granuloma|granulomatous]] [[inflammation]], [[vasculitis]], and [[necrosis]]
| style="background: #F5F5F5; padding: 5px;" |Biopsy
| style="background: #F5F5F5; padding: 5px;" |[[Anti-neutrophil cytoplasmic antibody|c-ANCA]]


[[Anti-neutrophil cytoplasmic antibody|p-ANCA]]
{{familytree | D01 | | | | | | D02 | | | |D01=<div style="float: left; text-align: center; height: 1.25em; width: 15em; padding: 1em; text-size: 85%;">Consider [[Thymoma surgery|surgery]]</div>|D02=<div style="float: left; text-align: center; height: 1.25em; width: 15em; padding: 1em; text-size: 85%;">Disease-specific management</div>}}
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
 
!Diseases
{{familytree/start}}
! colspan="1" rowspan="1" |Productive cough
! colspan="1" rowspan="1" |Hemoptysis
!Weight loss
!Other symptoms
!Auscultation
!Sputum analysis
!Nodule
!Content
!Other findings
!Histopathology
|'''Gold standard'''
!Additional findings
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Arteriovenous malformation|Pulmonary AVMs]]
<ref name="pmid11930021">{{cite journal |vauthors=Khurshid I, Downie GH |title=Pulmonary arteriovenous malformation |journal=Postgrad Med J |volume=78 |issue=918 |pages=191–7 |date=April 2002 |pmid=11930021 |pmc=1742331 |doi= |url=}}</ref>
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +/-
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" |
* [[Dyspnea|Dyspnoea]]
* [[Epistaxis]]
* [[Palpitation]]
* [[Chest pain]]


* [[Gastrointestinal bleeding|GI bleeding]]
* [[Telangiectasia|Mucocutaneous telangiectasia]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Bruit]]
| style="background: #F5F5F5; padding: 5px;" |[[Red blood cell|RBCs]]
| style="background: #F5F5F5; padding: 5px;" |
* Solitary or multiple nodules
* Round, oval, or polycyclic
* Size 1 to 5 cm
| style="background: #F5F5F5; padding: 5px;" |
* Feeding [[Pulmonary artery|pulmonary arteries]] and draining [[pulmonary veins]]
| style="background: #F5F5F5; padding: 5px;" |
* Well-defined borders
* [[Lung|Lower and middle third of the lung]]
| style="background: #F5F5F5; padding: 5px;" |
* Not recommended
| style="background: #F5F5F5; padding: 5px;" |[[Pulmonary angiography]]
| style="background: #F5F5F5; padding: 5px;" |N/A
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Pneumoconiosis]]
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | -
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
* [[Dyspnea|Dyspnoea]]
* [[Chest pain]]
| style="background: #F5F5F5; padding: 5px;" |
* Fine [[crackles]]
* [[Rhonchi]]
* Bronchial breath sounds
* Expiratory [[wheezing]]
* [[Egophony]]
* [[Bronchophony]]
| style="background: #F5F5F5; padding: 5px;" |[[Inorganic compound|Inorganic particle]]
| style="background: #F5F5F5; padding: 5px;" |
* Solitary or multiple nodules
* Size 1 - 10 cm
* In the upper lobes
| style="background: #F5F5F5; padding: 5px;" |
* N/A
| style="background: #F5F5F5; padding: 5px;" |
* Massive [[fibrosis]] or [[conglomerate]] masses
* Small [[Nodule (medicine)|nodular]] [[opacities]]
* [[lymphadenopathy]] [[Calcification|eggshell calcification]]
| style="background: #F5F5F5; padding: 5px;" |
* [[Calcification]]
* Central necrosis
* Dense [[collagen]]
* [[Cancer|Malignant cells]]
| style="background: #F5F5F5; padding: 5px;" |[[Computed tomography|CT scan]]
| style="background: #F5F5F5; padding: 5px;" |N/A
|}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 20:48, 4 March 2019


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Trusha Tank, M.D.[2]

new

Micropathology: Squamous cell carcinoma of the lung. H&E stain, By Nephron Wikimedia Commons
Gross pathology: Bronchial squamous lung cell cancer By John Hayman [Public domain], (Image source: Wikimedia Commons)
  1. Superior vena cava obstruction
  2. Partial anomalous pulmonary venous connection
  3. Esophageal achalasia
  4. Esophageal cancer
  5. Esophageal rupture
  6. Hiatus hernia
  7. Hilar lymphadenopathy
  8. Pneumomediastinum
  9. Sarcoidosis
  10. Lymphoma
  11. Neurilemmoma
  12. Non-Hodgkin lymphoma
  13. Teratoma
  14. Thymoma
  1. Thyroid cancer
  2. Goitre
  3. Mediastinal germ cell tumor,
  4. Mediastinal tumor,
  5. Mediastinitis
  1. Churg-Strauss syndrome
  2. Bronchogenic cyst,
  3. Dermoid cyst
  4. Anthrax:
  5. Tularemia
CT scan shows cystic mass which was located on the posterior to the lower esophagus later diagnosed as thoracic duct lymphangioma. Source:Case courtesy of Jin San Bok et al, Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital


CT scan showing a soft tissue density lesion within the left posterior mediastinum, in a paravertebral location. The lesion is closely related to the left neural exit foramen, but there is no definite extension into the spinal canal. The lesion does extend into the intercostal space. Case courtesy of Dr Paul Leong (Picture courtesy:Radiopedia)



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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]; Associate Editor(s)-in-Chief: Trusha Tank, M.D.[4], Amr Marawan, M.D. [5]

Synonyms and keywords: Mediastinal enlargement; mass in the mediastinum

Overview

The mediastinum is a non-delineated group of structures in the thorax (chest), surrounded by loose connective tissue. Since it is the central compartment of the thoracic cavity, and it contains a lot of important structures, it is the site of involvement of various tumors.

Causes

Initial Evaluation

 
 
 
 
Mediastinal Mass
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Workups

❑ CT chest with contrast
❑ Serum beta-HCG, AFP, if appropriate
❑ CBC, platelets
❑ PET-CT scan (optional)
❑ Pulmonary function tests if clinically indicated
❑ MRI chest if clinically indicated

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Thymic Tumor Likely
 
 
 
 
 
Thymic Tumor Unlikely
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Consider surgery
 
 
 
 
 
Disease-specific management
 
 
 

References

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