Imaging features and differential diagnoses of non-neoplastic diffuse mediastinal diseases.

Tabotta, Flavian; Ferretti, Gilbert R; Prosch, Helmut; Boussouar, Samia; Brun, Anne-Laure; Roos, Justus E; Ebner, Lukas; Letovanec, Igor; Brauner, Michel; Beigelman-Aubry, Catherine (2020). Imaging features and differential diagnoses of non-neoplastic diffuse mediastinal diseases. Insights into imaging, 11(1), p. 111. Springer 10.1186/s13244-020-00909-z

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Acute or chronic non-neoplastic diffuse mediastinal diseases have multiple causes, degrees of severity, and a wide range of management. Some situations require emergency care while others do not need specific treatment. Although the diagnosis may be suspected on chest X-ray, it is mainly based on CT. A delayed recognition is not uncommonly observed. Some findings may prompt the radiologist to look for specific associated injuries or lesions.This pictorial review will successively describe the various non-neoplastic causes of diffuse mediastinal diseases with their typical findings and major differentials.First, pneumomediastinum that can be provoked by extra- or intra-thoracic triggers requires the knowledge of patient's history or recent occurrences. Absence of any usual etiological factor should raise suspicion of cocaine inhalation in young individuals.Next, acute mediastinitis may be related to post-operative complications, esophageal perforation, or contiguous spread of odontogenic or retropharyngeal infections. The former diagnosis is not an easy task in the early stage, owing to the similarities of imaging findings with those of normal post-operative appearance during the first 2-3 weeks.Finally, fibrosing mediastinitis that is linked to an excessive fibrotic reaction in the mediastinum with variable compromise of mediastinal structures, in particular vascular and airway ones. Differential diagnosis includes tumoral and inflammatory infiltrations of the mediastinum.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Ebner, Lukas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1869-4101

Publisher:

Springer

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

30 Oct 2020 13:10

Last Modified:

01 Nov 2020 04:03

Publisher DOI:

10.1186/s13244-020-00909-z

PubMed ID:

33057984

Uncontrolled Keywords:

Acute mediastinitis Diffuse mediastinal diseases Fibrosing mediastinitis and mimickers Mediastinum Pneumomediastinum

BORIS DOI:

10.7892/boris.147176

URI:

https://boris.unibe.ch/id/eprint/147176

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