Mediastinal tumor
Introduction
Introduction to mediastinal tumor The mediastinum is located between the two sides of the lung, with the sternum and thoracic vertebra as its front and rear boundaries. There are many important organs, including large blood vessels, trachea, main bronchus, pericardium, esophagus, thymus and a large number of fat, nerves and lymphatic vessels. They are mediastinal tumors due to abnormal congenital development or acquired cysts or tumors. There are many kinds of tumors in the mediastinum, and there are primary and metastatic. The primary tumors are benign and common, but a considerable part is malignant. In order to indicate the location of the lesion in the mediastinum, the mediastinum can be divided into several parts. The sternum and the lower edge of the fourth thoracic vertebrae are divided into upper and lower parts. The mediastinal space containing many important organs is called the visceral mediastinum (middle) Mediastinal), the right trachea, the space before the pericardium is the anterior mediastinum; the posterior mediastinum is called behind the trachea and pericardium (including the esophagus and the paraspinal mediastinum). According to domestic statistics, the incidence of mediastinal tumors is the first with neurogenic tumors. Position, followed by teratogenic, thymic and thyroid tumors, the most cystic tumors. basic knowledge The proportion of illness: 0.0025% Susceptible people: no specific population Mode of infection: non-infectious Complications: dysphagia, myasthenia gravis, erythema
Cause
Mediastinal tumor
There are many tissues and organs in the mediastinum, and the source structure of the viviparous structure is complex. Therefore, there are many kinds of tumors in the mediastinum, and there are primary and metastatic. The primary tumors are more benign, but a considerable part is malignant. Causes and pathogenesis: Most of the causes are still unclear. Some tumors are implanted into the mediastinal cavity due to ectopic cells or tissues, and abnormal tumors become tumors.
Prevention
Mediastinal tumor prevention
There are no special preventive measures for this disease. Early detection and early treatment are the key to prevention.
Complication
Mediastinal tumor complications Complications, dysphagia, myasthenia erythema
Complicated with dyspnea and difficulty swallowing, malignant can occur metastasis, thymoma can be combined with myasthenia gravis and lupus erythematosus.
Symptom
Mediastinal tumor symptoms Common symptoms Sex on one side of the face... Chest pain Facial edema Swallowing difficulty Chest stagnation Malignant pleural effusion
Common symptoms are as follows:
(1) respiratory symptoms : chest tightness, chest pain usually occurs in the back of the sternum or the side of the chest. When most malignant tumors invade bones or nerves, the pain is severe. Cough is often caused by compression of the trachea or lung tissue, and hemoptysis is less common.
(2) symptoms of the nervous system : due to tumor compression or erosion of the nerve to produce various symptoms: such as tumor invasion and phrenic nerve can cause hiccups and diaphragmatic muscle paralysis; such as tumor invasion of the recurrent laryngeal nerve, can cause hoarseness; such as sympathetic involvement, Produces Horner's syndrome; chest pain or paresthesia can occur when intercostal nerve erosion occurs. For example, compression of the spinal nerve causes limb paralysis.
(3) Symptoms of infection : If the cyst is broken or the tumor infection affects the bronchial or lung tissue, a series of infection symptoms appear.
(4) compression symptoms : superior vena cava compression, common in the upper mediastinal tumor, more common in malignant thymoma and lymphoid malignancies. The esophagus and trachea are under pressure, and symptoms such as shortness of breath or hypopharyngeal obstruction may occur.
(5) Special symptoms : The teratoma breaks into the bronchus, and the patient coughs up sebum and hair. Bronchial cyst rupture and bronchial communication, showing symptoms of bronchopleural fistula. Very few patients with intrathoracic thyroid tumors have symptoms of hyperthyroidism. Patients with thymoma are sometimes accompanied by symptoms of myasthenia gravis.
Examine
Mediastinal tumor examination
(1) X-ray examination: conventional chest lateral position, X-ray photograph and fluoroscopy can make a preliminary diagnosis. Further examination methods include bronchography, tomography, angiography and mediastinal inflation.
(2) Endoscopy.
(3) Radioisotope inspection.
(4) Percutaneous biopsy.
(5) Experimental radiation therapy.
(6) Biopsy.
(7) Electronic computer X-ray layered photography inspection (CT).
(8) thoracotomy or sternal mediastinal incision, removal of mass or pathological examination of living tissue, diagnosis, timely surgical treatment.
Diagnosis
Diagnosis and diagnosis of mediastinal tumor
diagnosis
Chest X-ray examination: It is an important means to diagnose mediastinal tumors. The fluoroscopy can observe whether the mass moves up and down with swallowing, whether there is morphological change with breathing and whether there is pulsation, etc. X-ray positive lateral chest radiograph can show tumor location, density, shape Clear edge smoothness, presence or absence of calcification or bone shadow, CT or MRI can further show the relationship between tumor and adjacent tissues and organs, it is an essential examination, if necessary, for cardiovascular, bronchography, ultrasound can identify the essence Sexual, vascular or cystic neoplasms, radionuclide can assist in the diagnosis of retrosternal goiter, cervical lymph node biopsy, bronchoscopy, esophagoscopy, mediastinoscopy, thoracoscopic mediastinal mass biopsy, diagnostic radiotherapy, in Whether it can be reduced in the short term will help identify radioactive tumors such as malignant lymphoma.
Differential diagnosis : all mediastinal tumors should be distinguished from the following lesions
(1) Aortic aneurysm or anonymous aneurysm: An aneurysm located in the ascending aorta, aortic arch, and innominate artery, which needs to be distinguished from the mediastinal tumor. Under fluoroscopy, it can be seen that it is connected to the aorta, and it is difficult to separate and expand the pulsating block. X-ray wave radiography and serum Kanghua test can help differential diagnosis, and can be used for retrograde aortic angiography if necessary and conditional.
(2) paravertebral abscess: paraspinal abscess is located on both sides of the spine, showing symmetry. X-ray examination can show bone destruction and deformity. Combined with clinical manifestations can be diagnosed.
(3) Central type lung cancer: located in the hilar side of the side, the patient often has hemoptysis, cough and irritating cough. Layered radiography, bronchial lipiodol angiography, sputum examination of pathological cells can help to confirm the diagnosis.
(4) mediastinal lymphadenopathy: more common in adolescents, patients often have fatigue, night sweats, weight loss, low fever and other symptoms. X-ray shows lobulated or nodular shadows, calcification sometimes occurs in the mass, tuberculosis may be present in the lungs, and tuberculin test is mostly positive.
