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外科学教学课件:Primary Tumors of Mediastinum.ppt


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Primary Tumors of Mediastinum
The mediastinum is an anatomic division of the thorax extending from the diaphragm to the thoracic inlet.
Mediastinal disorders present as a number of clinical features. Many cases are asymptomatic, and the disorder is identified on routine chest radiographs. Most patients have clinical features related to local involvement of adjacent structures, tumor secretory factors, or immunologic factors.
Anatomy of Mediastinum
Borders:
Superior: the thoracic inlet
Inferior: the diaphragm
Anterior: the sternum
Posterior: the vertebral column
Lateral: the parietal pleura
Right mediastinal view
Left mediastinal view
Components of Mediastinal Compartments
Anterior
Visceral (middle)
Paravertebral (posterior)
Thymus
Pericardium/heart
Sympathetic chain
Internal thoracic vessels
Great vessels
Proximal intercostal nerve, artery, and vein
Internal thoracic lymph nodes
Trachea
Posterior paraesophageal lymph nodes
Prevascular lymph nodes
Proximal right and left mainstem
Intercostal lymph nodes
Fat and connective tissue
Esophagus
Phrenic nerve
Thoracic duct
Proximal azygos vein
Paratracheal and subcarinal lymph nodes (levels 2, 4, and 7)
Pleuropericardial lymph nodes
Fat and connective tissue
I. Anterior Mediastinal Masses
Differential Diagnosis of a Mass Lesion in the Anterior Mediastinal Compartment.
Neoplastic
Thyroid
Substernal goiter
Ectopic thyroid tissue
Thymus
Thymic hyperplasia
Thymoma
Thymic carcinoma
Thymic carcinoid
Thymic cysts
Teratoma
Mature teratoma
Immature teratoma
Lymphoma
THYMIC TUMORS
Thymic Masses.
Thymic hyperplasia

Thymoma

Thymic carcinoma

Thymic neuroendocrine tumors
Carcinoid
Small-cell carcinoma

Thymic cysts (nonthymomatous)

Thymolipoma

Metastases to the thymus
Thymoma
Thymomas represent the most common thymic tumor, and approximately 95% are l

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  • 时间2021-06-17