Histomorphological Spectrum of Mediastinal Masses with Special Emphasis on Rare Lesions
Introduction: Mediastinal lesions are not frequently observed in routine clinical practice. A wide variety of disease process can occur within the mediastinum. Tissue from needle biopsies forms the major diagnostic material. There is need for detailed studies to make pathologists aware of the wi...
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doaj-760068844bf9442ab7aae084e1ee24a92021-01-22T11:53:14ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2020-08-01148EC01EC0510.7860/JCDR/2020/44483.13884Histomorphological Spectrum of Mediastinal Masses with Special Emphasis on Rare LesionsSakthisankari Shanmuga Sundaram0S Vidhyalakshmi1Assistant Professor, Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.Associate Professor, Department of Pathology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.Introduction: Mediastinal lesions are not frequently observed in routine clinical practice. A wide variety of disease process can occur within the mediastinum. Tissue from needle biopsies forms the major diagnostic material. There is need for detailed studies to make pathologists aware of the wide histological spectrum and to know the unusual lesions that can be encountered during diagnosis. Aim: To describe the histomorphological spectrum of various mediastinal lesions and to highlight the rare lesions that posed a diagnostic challenge. Materials and Methods: This was a retrospective study done on all mediastinal masses over a period of two years from January 2016 to December 2018. The clinical data and imaging findings were collected from the test request forms and patients’ files for all the cases. Haematoxylin and eosin stained slides of all cases and immunohistochemistry markers and cytochemical stains wherever done were reviewed and analysed. Mean, median and percentage were used for statistical analysis. Results: Thirty-four cases of mediastinal lesions were included in the study. Of these, 28 cases (82.4%) presented as anterior mediastinal masses, three cases (8.8%) each in the middle and posterior mediastinum. Thymoma (n=15) followed by lymphoma (n=4) were the most frequent neoplasms reported. There were five lesions which were rare in the mediastinum with unusual presentation that posed diagnostic difficulties. These lesions included Primitive neuroectodermal tumour in an adult, Primary Mediastinal B Cell Lymphoma (PMBCL), Malignant Peripheral Nerve Sheath Tumour (MPNST) with nodal metastasis, Seminoma deposits in mediastinal node occurring as late relapse and dedifferentiation of thyroid carcinoma in mediastinal node metastasis without an obvious primary. Conclusion: Primary mediastinal tumours were more frequent than metastasis. Although thymomas and lymphomas are dealt extensively in literature, this article highlights the fact that pathologists must be aware of those lesions that don’t display the classical histological and/or clinical features as observed in this study.https://jcdr.net/articles/PDF/13884/44483_CE[Ra1]_F(KM)_PF1(Chr_SL)_PFA(SL)_PN(SL).pdfmalignant peripheral nerve sheath tumourmediastinummediastinal b cell lymphomamorphological spectrumprimitive neuroectodermal tumour |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sakthisankari Shanmuga Sundaram S Vidhyalakshmi |
spellingShingle |
Sakthisankari Shanmuga Sundaram S Vidhyalakshmi Histomorphological Spectrum of Mediastinal Masses with Special Emphasis on Rare Lesions Journal of Clinical and Diagnostic Research malignant peripheral nerve sheath tumour mediastinum mediastinal b cell lymphoma morphological spectrum primitive neuroectodermal tumour |
author_facet |
Sakthisankari Shanmuga Sundaram S Vidhyalakshmi |
author_sort |
Sakthisankari Shanmuga Sundaram |
title |
Histomorphological Spectrum of Mediastinal Masses with Special Emphasis on Rare Lesions |
title_short |
Histomorphological Spectrum of Mediastinal Masses with Special Emphasis on Rare Lesions |
title_full |
Histomorphological Spectrum of Mediastinal Masses with Special Emphasis on Rare Lesions |
title_fullStr |
Histomorphological Spectrum of Mediastinal Masses with Special Emphasis on Rare Lesions |
title_full_unstemmed |
Histomorphological Spectrum of Mediastinal Masses with Special Emphasis on Rare Lesions |
title_sort |
histomorphological spectrum of mediastinal masses with special emphasis on rare lesions |
publisher |
JCDR Research and Publications Private Limited |
series |
Journal of Clinical and Diagnostic Research |
issn |
2249-782X 0973-709X |
publishDate |
2020-08-01 |
description |
Introduction: Mediastinal lesions are not frequently observed in
routine clinical practice. A wide variety of disease process can
occur within the mediastinum. Tissue from needle biopsies forms
the major diagnostic material. There is need for detailed studies
to make pathologists aware of the wide histological spectrum
and to know the unusual lesions that can be encountered during
diagnosis.
Aim: To describe the histomorphological spectrum of various
mediastinal lesions and to highlight the rare lesions that posed
a diagnostic challenge.
Materials and Methods: This was a retrospective study done on
all mediastinal masses over a period of two years from January
2016 to December 2018. The clinical data and imaging findings
were collected from the test request forms and patients’ files for
all the cases. Haematoxylin and eosin stained slides of all cases
and immunohistochemistry markers and cytochemical stains
wherever done were reviewed and analysed. Mean, median and
percentage were used for statistical analysis.
Results: Thirty-four cases of mediastinal lesions were included
in the study. Of these, 28 cases (82.4%) presented as anterior
mediastinal masses, three cases (8.8%) each in the middle
and posterior mediastinum. Thymoma (n=15) followed by
lymphoma (n=4) were the most frequent neoplasms reported.
There were five lesions which were rare in the mediastinum
with unusual presentation that posed diagnostic difficulties.
These lesions included Primitive neuroectodermal tumour
in an adult, Primary Mediastinal B Cell Lymphoma (PMBCL),
Malignant Peripheral Nerve Sheath Tumour (MPNST) with nodal
metastasis, Seminoma deposits in mediastinal node occurring
as late relapse and dedifferentiation of thyroid carcinoma in
mediastinal node metastasis without an obvious primary.
Conclusion: Primary mediastinal tumours were more frequent
than metastasis. Although thymomas and lymphomas are dealt
extensively in literature, this article highlights the fact that
pathologists must be aware of those lesions that don’t display
the classical histological and/or clinical features as observed in
this study. |
topic |
malignant peripheral nerve sheath tumour mediastinum mediastinal b cell lymphoma morphological spectrum primitive neuroectodermal tumour |
url |
https://jcdr.net/articles/PDF/13884/44483_CE[Ra1]_F(KM)_PF1(Chr_SL)_PFA(SL)_PN(SL).pdf |
work_keys_str_mv |
AT sakthisankarishanmugasundaram histomorphologicalspectrumofmediastinalmasseswithspecialemphasisonrarelesions AT svidhyalakshmi histomorphologicalspectrumofmediastinalmasseswithspecialemphasisonrarelesions |
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1724327834719092736 |