• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.744-749
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• 2022

Fibrosing mediastinitis is a rare benign disorder characterized by the proliferation of dense fibrous tissue within the mediastinum. It typically manifests as localized or infiltrative soft-tissue masses in the middle mediastinum or hilar area, which cause compression and encasement of adjacent mediastinal structures, such as the vessels or airway. Here, we report a rare case of fibrosing mediastinitis in a 13-year-old girl that presented as a middle mediastinal mass lesion on CT scan with obliterating left lower lobar bronchus. The patient's symptoms and follow-up chest CT showed significant improvement following systemic corticosteroid treatment. As fibrosing mediastinitis can improve with systemic steroid therapy, radiologists must be aware of its radiologic findings when discriminating between infiltrating soft tissue lesions in the mediastinum.

• Journal of Chest Surgery
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• v.37 no.4
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• pp.386-389
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• 2004

Descending nectorizing mediastinitis (DNM). represents a virulent form of mediastinal infection requiring prompt diagnosis and treatment to reduce the high morbidity mortality associated with this disease. Intr. avenous broad-spectrum antibiotic therapy alone is not efficient without adequate surgical drainage of the cervical and mediastinal collections, extensive debridement and excision of necrotic tissue, and wide mediastino-pleural irrigation. A 38-year-old man admitted via emergency room with painful left neck swelling and uncontrolled high fever. Chest computed tomogram showed left paratracheal abscess descending into the superior and anterior mediastinum. Transcervical mediastinal drainage was performed with 26 Fr. chest tube and left paratracheal drainage was performed with Penrose drain in urgency. Culture and sensitivity test grew Yeast. The drains removed via gradually shortening on day 39 after surgery.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.40-45
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• 1998

Recently, video-assisted thoracoscopic surgery for mediastinal lesions has been considered a new effective therapeutic method. From March, 1992 to April, 1997, 33 cases of video assisted thoracoscopic surgery for mediastinal lesions were performed. Gender distribution was 16 males and 17 females. Average age was 42 years old(ranged from 14 to 69). The locations of lesions were anterior mediastinum in 14 cases, middle mediastinum in 5 cases, posterior mediastinum in 11 cases, and superior mediastinum in 3 cases. These included 9 neurilemmomas, 5 benign cystic teratoma, 4 pericardial cysts, 2 ganglioneuroma, 2 thymus, 2 thymic cyst, 1 thymoma, 2 esophageal leiomyomas, 1 dermoid cyst, 1 lipoma, 1 malignant lymphoma, 1 bronchogenic cyst, 1 pericardial effusion, and 1 Boerhaave's disease with empyema. Working window was needed in 6 cases. We converted to open thoracotomy in 6 cases. Reasons of convertion to open thoracotomy were large sized mass(1), severe adhesion(3), and difficult location to approach(2). The average operation time was 116min($\pm$56 min). The average chest tube drainage time was 4.7days. The average hospital stay was 8.7 days. Operative complications were atelectasis(2), empyema with mediastinitis(1), recurrent laryngeal nerve palsy(1), and plenic nerve palsy(1). In conclusion, VATS for mediastinal lesions were performed with shorter operation time and hospital stay, and lesser complications and pain than those of conventional thoracotomy.

• Journal of Chest Surgery
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• v.36 no.6
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• pp.448-450
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• 2003

Lipoma is a circumscribed mesenchymal tumor originating from the adipose tissue. The lesion is usually small and asymptomatic. The most common location is in the neck region, however, lipoma can be found in the mediastinum in rare occasions. Although lipoma reach to the large proportions in the mediastinum, it rarely compresses the neurovascular structure. We present a case of a 58-year-old man, in which a hourglass-type cervicomediastinal lipoma produced Horner's syndrome with voice change. The man presented a swelling at the right side of his neck, ptosis and anhidrosis on the right side of his face, and right chest discomfort. After the removal of the mass, all the symptoms which had been provoked by compression, as well as Horner's syndrome and hoarseness, nearly disappeared.

• Journal of Chest Surgery
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• v.39 no.6 s.263
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• pp.470-474
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• 2006

Background: Mediastinal lymph node metastasis is an important factor for staging and prognosis of non-small cell lung cancer (NSCLC), so accurate diagnosis is essential for treatment. Mediastinoscopy provides histopathological diagnosis of mediastinal lymphnode metastasis in NSCLC. The efficacy of mediastinoscopy was investigated. Material and Method: From Jun, 1999 to Aug, 2005, mediastinoscopic lymph node biopsy was performed to 348 patients with NSCLC. Patients characteristics, radiologic findings, mediastinoscopic results and pathologic stages were evaluated for investigation of safety and efficacy of modiastinoscopy in NSCLC. Result: There was 263 male and 85 female patients and the mean age was $62.1{\pm}8.5$ years. By radiologic study for mediastinal lymph node metastasis, 203 patients were negative and 145 patients were positive. Mean procedure time was $55.5{\pm}16.5$ minutes and biopsy was peformed at $2.2{\pm}1.0$ lymph node stations. There were only transient complications (1.7%) during the procedure, without other complication and mortality. There was 7.8% of false negative result in mediastinoscopy. Sensitivity (77.5% vs 71.9%, p=0.012), specificity (100% vs 74.4%, p=0.00), and accuracy (92.2% vs 73.6%, p=0.00) of mediastinoscopy were more superior than that of radiologic study for the diagnosis of mediastinal lymph node metastasis in NSCLC. Conclusion: Mediastinoscopy is a safe and effective modality for diagnosis of mediastinal lymph node metastasis in NSCLC.

• Journal of Chest Surgery
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• v.34 no.11
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• pp.883-886
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• 2001

Mediastinal fibrosis is uncommon but may result in entrapment and erosion of vital mediastinal structures by fibrous tissues. Idiopathic mediastinal fibrosis involved esophagus is very rare, and only a few cases have ever been reported. Such idiopathic mediastinal fibrosis involved esophagus is an enigmatic inflammatory fibrous tissue proliferation, but the treatment has not yet been clearly defined. We had successfully treated in such a case with partial esophagolysis and esophagomyotomy.

• Journal of Chest Surgery
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• v.43 no.2
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• pp.208-211
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• 2010

An occurrence of hemangioma in the mediastinum is a very rare, accounting for less than 0.5% of mediastinal tumors. Capillary hemangiomas and cavernous hemangiomas consists of over 90% of mediastinal hemangiomas. However, venous hemangioma has never been reported in South Korea and has also very rarely been reported worldwide. We found mediastinal solid mass, as an incidental finding during a follow-up chest CT scan of a 44-year-old female patient who had undergone colon cancer surgery. We performed a mediastinoscopic biopsy. We did a thoracotomy to remove this mass because hemorrhage and found a totally resected venous hemangioma.

• Tuberculosis and Respiratory Diseases
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• v.56 no.6
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• pp.646-656
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• 2004

Background : The aim of this study was to elucidate the mediastinal lymphatic drainage of nonsmall- cell lung cancer (NSCLC). Methods : We retrospectively analyzed the frequency of enlarged mediastinal lymph node (LN) in 256 NSCLC patients with N2 or N3 diseases on CT scan, especially with respect to the location of primary tumor. Results : In 57 patients with right upper lobe (RUL) tumors, right lower paratracheal LN (89.5%) was the most commonly enlarged, followed by subcarinal LN (54.4%). In 61 patients with left upper lobe (LUL) tumors, left lower paratracheal (70.5%) and subaortic LNs (52.5%) were commonly enlarged. Subcarinal LN enlargement without ipsilateral superior mediastinal LN enlargement was rarely found in both upper lobe tumors; RUL 8.8%, LUL 6.6%. In patients with right or left lower lobe (RLL or LLL) tumors, the most commonly enlarged LN was subcarinal; 88.2%, 65.7%, respectively. In RLL tumors with both subcarinal and superior mediastinal LN enlargements, the frequency of ipsilateral superior mediastinal LN involvement was similar to that of bilateral superior mediastinal involvement. In LLL tumors with both subcarinal and superior mediastinal LN enlargements, bilateral superior mediastinal involvement was more frequent than ipsilateral superior mediastinal involvement. Conclusion : The results of this study suggest that both upper lobe tumors are mainly drained directly to ipsilateral superior mediastinal LNs, and that both lower lobe lesions are drained to superior mediastinal LN via subcarinal LNs.

• Journal of Chest Surgery
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• v.35 no.9
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• pp.697-700
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• 2002

Primary malignant melanoma of the mediastinum is extremely rare : To date, there have been only 8 cases reported in the literature. We report a case of a 50-year-old woman presented with an anterior mediastinal mass. The mass invaded the lung parenchyme of right upper lobe, which was wedge-resected with the mass. Microscopically, spindle or polygonal tumor cells with prominent nucleoli and intracytoplasmic melanin pigments are characterized and Fontana stain confirmed the presence of melanin pigment. Immunohistochemical studies showed diffuse positive staining for HMB45, S100 protein and vimentin, which further suggested melanoma.

• Journal of the Korean Society of Radiology
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• v.83 no.3
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• pp.597-607
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• 2022

The mediastinum is the most prevalent site of extragonadal teratomas. Patients with mediastinal mature teratomas are usually young adults, and the condition does not show significant sexual differences. Mediastinal teratomas are mostly located in the anterior mediastinum. Patients are usually asymptomatic, although they can have several complications when the teratomas become large or rupture. Most mediastinal teratomas can be diagnosed using CT. Diagnosing ruptured or malignant teratomas is challenging because of their atypical clinical and radiological presentations. In this article, we describe various manifestations of mediastinal teratomas, with an emphasis on radiologic features.