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J Thorac Oncol. 2019 Dec 20. pii: S1556-0864(19)33848-1. doi: 10.1016/j.jtho.2019.12.108. [Epub ahead of print]

The Distribution of Mediastinal Lesions across Multi-Institutional, International, Radiology Databases.

Author information

1
Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, MN, USA. Electronic address: Roden.anja@mayo.edu.
2
Department of Thoracic Surgery, Shanghai Chest Hospital, Jiaotong University Medical School, China.
3
Department of Radiology, Shanghai Chest Hospital, Jiaotong University Medical School, China.
4
Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
5
Department of Radiology, Mayo Clinic Rochester, MN, USA.
6
Department of Health Sciences Research, Mayo Clinic Rochester, MN, USA.
7
Division of Medical Oncology, Department of Oncology; Mayo Clinic Rochester, MN, USA.
8
The Chaim Sheba Medical Center, affiliated with the Tel Aviv University, Tel Aviv, Israel.
9
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
10
Curie Montsouris Thorax Institute, Institute Curie, Paris, France.
11
Radiology Department, Cochin hospital, University of Paris, Paris, France.
12
Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
13
Section of Thoracic Surgery, Yale University School of Medicine, New Haven, CT, USA.
14
NYU Langone Health, NYU School of Medicine, USA.
15
CCSEO and Queen's University, Kingston, Canada.
16
Department of Advanced Biomedical Sciences. University Federico II Naples, Italy.
17
Rare Tumours Reference Center of Campania Region (CRTR), University Federico II of Naples, Naples, Italy.
18
Department of Pathology, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy.
19
Department of Thoracic Surgery, Mount Sinai Health System, Icahn School of Medicine at Mount Sinai, New York, NY; Valley/Mount Sinai Comprehensive Cancer Care, Paramus, NJ; Department of Surgery, The Valley Hospital, Ridgewood, NJ, USA.

Abstract

BACKGROUND:

Mediastinal lesions are uncommon; studies on their distribution are in general small and from a single institution. Furthermore, these studies are usually based on pathology or surgical databases and therefore miss many lesions that are not biopsied and/or resected. Our aim was to identify the distribution of lesions in the mediastinum in a large international, multi-institutional cohort.

MATERIAL AND METHODS:

At each participating institution, a standardized retrospective radiology database search for interpretations of CT, PET-CT and MRI scans including any of the following terms: "mediastinal nodule", "mediastinal lesion", "mediastinal mass" or "mediastinal abnormality" was performed (2011-2014). Standardized data were collected. Statistical analysis was performed.

RESULTS:

Amongst 3,308 cases, thymomas (27.8%), benign mediastinal cysts (20.0%) and lymphomas (16.1%) were most common. The distribution of lesions varied amongst mediastinal compartments; thymomas (38.3%), benign cysts (16.8%) and neurogenic tumors (53.9%) were the most common lesions in the prevascular, visceral and paravertebral mediastinum, respectively (p<0.001). Mediastinal compartment was associated with age; patients with paravertebral lesions were the youngest (p<0.0001). Mediastinal lesions differed by continent/country with benign cysts being the most common mediastinal lesions in China, thymomas in Europe and lymphomas in North America and Israel (p<0.001). Benign cysts, thymic carcinomas, and metastases were more commonly seen in larger hospitals, while lymphomas and thymic hyperplasia occurred more often in smaller hospitals (p<0.01).

CONCLUSIONS:

Our study confirmed that spectrum and frequency of mediastinal lesions depends on mediastinal compartment and age. This information provides helpful demographic data and is important when considering the differential diagnosis of a mediastinal lesion.

PMID:
31870881
DOI:
10.1016/j.jtho.2019.12.108

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