Spectrum of malignant mediastinal masses at a tertiary care centre in Central India

Yadlapalli C. Deepak, Vishesh Gumdal, Ankur Punia, Renu Mishra, Prakash G. Chitalkar, Amar Jain


Background: Malignant mediastinal masses can develop from structures that are normally located or pass through the mediastinum during development, as well as from metastases of malignancies that arise elsewhere in the body. Since many tumors that occur in the mediastinum are undifferentiated and have overlapping histologic features, one must consider a broad differential diagnosis and perform a thorough evaluation. This is particularly important since appropriate therapy for various mediastinal tumors differs considerably and may significantly impact survival.

Methods: Ours was a retrospective descriptive study of 48 patients who presented or referred to medical oncology department from January 2014 to December 2017 and in whom malignant cause of mediastenal mass was established. All details of the patients pertinent epidemiology, clinical history and pathological including immunohistochemistry details were studied.

Results: Out of 48 patients,14 cases (29.2%) were in adolescent and young adult age group (15-29 years). Majority of the patients were symptomatic (91.6%) with most common being cough (87.5%) followed by chest pain (81.5%) and dyspnoea (79.1%). Four of the patients presented with superior vena-caval syndrome. Most of the tumors (64.6%) are in anterior mediastenum region. Histopathological examination revealed non-hodgkins lymphoma in 31.25%, Hodgkins lymphoma in 18.75%, leukaemia in 6.25%, germ cell tumor in 8.33%, thymic neoplasms in 4.16%, neurogenic tumors in 4.16%, lung carcinoma in 10.4% and metastatic carcinoma in 10.4%.

Conclusions: Malignant mediastinal masses have a broad range of diagnosis, establishing of which is important. While imaging help in narrowing the differential diagnosis, adequate pathological categorization should be done as many patients responds to specific line of therapy.


Lymphoma, Malignancy, Mediastinal mass

Full Text:



Duwe BV, Sterman DH, Musani AI. Tumors of the mediastinum. Chest. 2005;128:2893-909.

Bagheri R, Afghani R, Ziaollah Haghi S, Fattahi Masoum SH, Zarehparvar Moghaddam S, Akglaghi S. Evaluation of 95 cases with Mediastinal tumors. J Cardiothorac Med. 2015;3(1):249-53.

Kane GC, Almeida FA Jr. Approach to Mediastinal Masses. Hospital physician pulmonary disease board review manual. 2007;12:2-13.

Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L. A diagnostic approach to the mediastinal masses. Insights into imaging. 2013 Feb 1;4(1):29-52.

Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L. A diagnostic approach to the mediastinal masses. Insights Imaging. 2013;4:29-52.

Takahashi K, Al-Janabi NJ. Computed tomography and magnetic resonance imaging of mediastinal tumors. J Magn Reson Imaging. 2010;32:1325-39.

Karki S, Chalise S. Analysis of mediastinal lesions: a study of 27 cases. J of Patholo of Nep. 2011;1:114-7.

Dubashi B, Cyriac S, Tenali SG. Clinicopathological analysis and outcome of primary mediastinal malignancies: a report of 91 cases from a single institute. Ann Thorac Med. 2009;4:104-42.

Davis RD Jr, Oldham HN, Sabiston DC Jr. Primary cysts and neoplasms of the mediastinum: recent changes in clinical presentation, methods of diagnosis, management, and results. Ann Thorac Surg. 1987;44:229-37.

Shrivastava CP, Devgarha S, Ahlawat V. Mediastinal tumors: A clinicopathological analysis. Asian Cardiovasc Thorac Ann. 2006;14:102‑4.

Rahman AR, Sedera MA, Mourad IA, Aziz SA, Saber TK, Alsakary MA. Posterior mediastinal tumors: outcome of surgery. J Egypt Natl Canc Inst. 2005 Mar 1;17(17):1-8.

Aroor AR, Prakasha SR, Seshadri S, Teerthanath S, Raghuraj U. A Study of Clinical Characteristics of Mediastinal Mass. J Clin Diagn Res. 2014;8:77-80.