Mediastinal Tumors and Cysts in the Pediatric Population
Section snippets
The Normal Pediatric Thymus
The normal pediatric thymus is relatively larger than in adults and it is important in the development of the child's immune system. It normally weighs about 15 g at birth and 35 g at puberty, at which time it involutes and is gradually replaced with fat. The size of the thymus is correlated to the weight of the infant. The generous thymus in infancy is sometimes mistaken for true pathology causing superior anterior mediastinal widening (Figs. 1 and 2). On CT, the thymus has the same density as
Teratomas
Teratomas are the most common mediastinal germ cell tumor and are composed of all three germinal layers. They are usually in the anterior mediastinum closely associated with the thymus and present with a large mass. They may also protrude into the neck from the mediastinum. They appear benign and encapsulated and they are frequently cystic (Fig. 9). They are often inhomogeneous with areas of cystic change, solid tissue, and areas of calcification. They contain mature ectodermal elements such as
Posterior mediastinal masses
Posterior mediastinal masses are most often neurogenic tumors in the paravertebralsulcus. Neurogenic tumors in children have a much higher rate of malignancy than in adults. These tumors may arise from the sympathetic ganglia (ganglioma, ganglioneuroblastoma, and neuroblastoma), the intercostal nerves (neurofibroma, neurilemoma, and neurosarcoma) and the paraganglia cells (paraganglioma).
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Cited by (56)
Unilocular thymic cyst with features of intra-thymic bronchogenic cyst: A clinicopathological correlation of 4 cases
2022, Pathology Research and PracticeCitation Excerpt :Essentially, the main distinction between those cystic lesions is as its name implies, the presence of a single cystic structure or the presence of a structure containing several cystic compartments. It is also known that multilocular thymic cyst is a lesion more common in adults, while unilocular thymic cyst is a lesion more common in the pediatric age group [3,4]. Herein, we highlight the occurrence of four unilocular thymic cysts occurring in adults and bearing features of bronchogenic cysts.
Multilocular thymic cyst (MTC) and other tumors with MTC features: Pitfalls in diagnosis
2022, Seminars in Diagnostic PathologyCitation Excerpt :However, the clinical appearance and pathogenesis involved in those two cystic thymic lesions is different. Unilocular thymic cysts may be congenital in nature and more common in the pediatric age group while multilocular thymic cysts appear to be acquired in nature and predominantly occurring in the adult population.1-10 Therefore, if to our exclusion of thymic cysts, we add the unilocular thymic cyst, then we are left with a small group of tumors that despite being rather limited in size, expands the entire spectrum of tumoral conditions that can be seeded in the mediastinal compartment.
Mediastinal thymoma: A difficult diagnosis in the pediatric age
2021, Radiology Case ReportsCitation Excerpt :Thymoma is a slow-growing tumor that tends to invade surrounding anatomic structures but rarely develops distant metastases [5-7]. Most children are asymptomatic, and the diagnosis is most often after the occasional finding of a mediastinal enlargement evidenced by a routine chest X-ray taken for other clinical reasons; one-third of pediatric patients presents symptoms due to the compression of the tumor mass on adjacent mediastinal structures, such as cough, dyspnea, chest pain, dysphagia or superior vena cava syndrome [2,5–7]. Paraneoplastic syndromes such as myasthenia gravis, pure red blood cell aplasia, acquired hypogammaglobulinemia, and connective tissue disorders rarely occur in children with thymoma [6–7].
My, what a big thymus you have! Neonate/infant mediastinal masses
2021, Pediatric Imaging for the Emergency ProviderTumors of the Chest
2019, Kendig's Disorders of the Respiratory Tract in Children, Ninth EditionSubcutaneous bronchogenic cyst: Report of five cases and review of the literature
2017, Journal of Pediatric Surgery Case Reports