Pub Date : 2019-07-01DOI: 10.1093/med/9780199858064.003.0076
J. Bueno
Sarcoidosis is a systemic disease of unknown etiology, characterized by noncaseating epithelioid cell granulomas. Patients with sarcoidosis are frequently asymptomatic and may be diagnosed incidentally because of an abnormal imaging study. Sarcoidosis is a diagnosis of exclusion that warrants pathological confirmation in all cases. The distribution of granulomas in the lungs is characteristic and correlates with imaging findings; non-necrotizing granulomas classically exhibit a perilymphatic distribution. On chest radiography, the presence of bilateral hilar and right paratracheal lymphadenopathy, particularly in a young asymptomatic patient, should raise the possibility of sarcoidosis. On CT, a perilymphatic distribution (peribronchovascular, subpleural, septal) of abnormalities in the appropriate clinical context is highly specific for sarcoidosis.
{"title":"Sarcoidosis","authors":"J. Bueno","doi":"10.1093/med/9780199858064.003.0076","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0076","url":null,"abstract":"Sarcoidosis is a systemic disease of unknown etiology, characterized by noncaseating epithelioid cell granulomas. Patients with sarcoidosis are frequently asymptomatic and may be diagnosed incidentally because of an abnormal imaging study. Sarcoidosis is a diagnosis of exclusion that warrants pathological confirmation in all cases. The distribution of granulomas in the lungs is characteristic and correlates with imaging findings; non-necrotizing granulomas classically exhibit a perilymphatic distribution. On chest radiography, the presence of bilateral hilar and right paratracheal lymphadenopathy, particularly in a young asymptomatic patient, should raise the possibility of sarcoidosis. On CT, a perilymphatic distribution (peribronchovascular, subpleural, septal) of abnormalities in the appropriate clinical context is highly specific for sarcoidosis.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"49 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116692671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/MED/9780199858064.003.0087
B. Carter
A group of several miscellaneous lesions may arise within one or more of the mediastinal compartments that are distinct from benign or malignant neoplasms, cysts, lymphadenopathy, and vascular lesions. Such entities cannot be classified as one specific disease type, and include extramedullary hematopoiesis and multiple types of herniations, specifically hiatal, paraesophageal and Morgagni hernias. Extramedullary hematopoiesis typically manifests as paravertebral masses that may exhibit fat attenuation or signal. Hiatal and paraesophageal hernias are common abnormalities in which the stomach herniates into the thorax through the esophageal hiatus. Morgagni hernias occur through an anterior diaphragmatic defect and typically contain omental fat but may also contain liver and bowel. As with other abnormalities of the mediastinum, these lesions may first be identified on chest radiography. However, correlation with pertinent clinical history and cross-sectional imaging, typically contrast-enhanced computed tomography, is necessary for definitive diagnosis.
{"title":"Miscellaneous Lesions of the Mediastinum","authors":"B. Carter","doi":"10.1093/MED/9780199858064.003.0087","DOIUrl":"https://doi.org/10.1093/MED/9780199858064.003.0087","url":null,"abstract":"A group of several miscellaneous lesions may arise within one or more of the mediastinal compartments that are distinct from benign or malignant neoplasms, cysts, lymphadenopathy, and vascular lesions. Such entities cannot be classified as one specific disease type, and include extramedullary hematopoiesis and multiple types of herniations, specifically hiatal, paraesophageal and Morgagni hernias. Extramedullary hematopoiesis typically manifests as paravertebral masses that may exhibit fat attenuation or signal. Hiatal and paraesophageal hernias are common abnormalities in which the stomach herniates into the thorax through the esophageal hiatus. Morgagni hernias occur through an anterior diaphragmatic defect and typically contain omental fat but may also contain liver and bowel. As with other abnormalities of the mediastinum, these lesions may first be identified on chest radiography. However, correlation with pertinent clinical history and cross-sectional imaging, typically contrast-enhanced computed tomography, is necessary for definitive diagnosis.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128359793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-01DOI: 10.1093/med/9780199858064.003.0085
B. Carter
Glandular enlargement in the mediastinum is usually due to hyperplasia of thymus in the anterior mediastinum or thyroid enlargement with intramediastinal growth. Thymic enlargement is typically due to rebound hyperplasia associated with chemotherapy, radiation therapy, and stresses. Rebound thymic hyperplasia manifests as diffuse, symmetric enlargement of the thymus. MRI may be helpful in distinguishing thymic hyperplasia from neoplastic involvement of the thymus, as the former lose signal on opposed-phase T1-weighted MR imaging. Thyroid goiters may originate in the neck and migrate into the mediastinum or arise from an ectopic focus of mediastinal thyroid tissue. Goiters manifest as mediastinal masses that are similar in appearance to the thyroid gland, with intrinsic hyperdensity, hyperenhancement, foci of calcification and cystic change.
{"title":"Glandular Enlargement","authors":"B. Carter","doi":"10.1093/med/9780199858064.003.0085","DOIUrl":"https://doi.org/10.1093/med/9780199858064.003.0085","url":null,"abstract":"Glandular enlargement in the mediastinum is usually due to hyperplasia of thymus in the anterior mediastinum or thyroid enlargement with intramediastinal growth. Thymic enlargement is typically due to rebound hyperplasia associated with chemotherapy, radiation therapy, and stresses. Rebound thymic hyperplasia manifests as diffuse, symmetric enlargement of the thymus. MRI may be helpful in distinguishing thymic hyperplasia from neoplastic involvement of the thymus, as the former lose signal on opposed-phase T1-weighted MR imaging. Thyroid goiters may originate in the neck and migrate into the mediastinum or arise from an ectopic focus of mediastinal thyroid tissue. Goiters manifest as mediastinal masses that are similar in appearance to the thyroid gland, with intrinsic hyperdensity, hyperenhancement, foci of calcification and cystic change.","PeriodicalId":415668,"journal":{"name":"Chest Imaging","volume":"32 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133110462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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