PURPOSE: Using dynamic range compression (DRC) processing, this study compared the detectability ofmediastinal lines by conventional film screen rediography (FS) and by storage phosphor digital radiography(DR). MATERIALS AND METHODS: We selected 200 normal consecutive chest radiographs (100 FS, 100 DR) ; dynamic rangecompression was applied to DR processing and moving grids were used in both systems. Seven mediastinal lines (leftfaraspinal, right paraspinal, azygoesophageal, left para-aortic, posterior junctional, anterior junctional andright paratracheal) were scored from 0 point to 3 point(0:not visible, 1:suspiciously visible, 2:visible, but notclear, 3: clearly visible) according to visibility and sharpness, as agreed by a radiologist and a resident. Thedifferences between the two modalities were compared and analyzed by chi-square test. RESULTS: Among the 1400mediastinal lines analyzed, 419 lines by DR(59.9%) and 232 lines by FS(33.1%) were scored more than 2 points. Inall mediastinal lines except the left para-aortic, DR was more detectable and clearer than FS, with statisticalsignificance(P<.01). CONCLUSION: DR processed with DRC visualizes mediastinal lines more frequently and clearlythan conventional FS, and is therefore thought to be useful for the evaluation of mediastinal diseases.
Mediastinal Diseases ; Radiographic Image Enhancement ; Radiography* ; Radiography, Thoracic

We report here on a rare case of an ectopic pancreatic tissue in the anterior mediastinum. A 32-year-old woman without any symptoms was transferred to our hospital because of an abnormal large mediastinal shadow on her chest radiograph during a checkup. The computed tomography (CT) scan revealed a giant cystic-solid mass that measured 16 x 13 x 8 cm and it was located in the center of the anterior mediastinum and it symmetrically grew to two sides. On enhanced CT scans, the solid component of the mass showed marked enhancement. We performed total surgical resection of the mass and complete pancreatic tissues were verified on the pathological examination.
Adult ; Choristoma/*radiography/surgery ; Diagnosis, Differential ; Female ; Humans ; Mediastinal Diseases/*radiography/surgery ; *Pancreas ; Tomography, X-Ray Computed

We experienced a case of a tracheoesophageal cyst in the posterior mediastinum of a three-year-old girl, who complained of cough and fever. We confirmed this case by computerized tomography and pathologic examination after surgical resection. A brief review of the literature is presented.
Case Report ; Child, Preschool ; Cysts/*pathology/radiography/surgery ; Esophageal Cyst/*pathology/radiography/surgery ; Female ; Human ; Mediastinal Diseases/*pathology/radiography ; Trachea/*pathology/radiography/surgery

We experienced a case of a tracheoesophageal cyst in the posterior mediastinum of a three-year-old girl, who complained of cough and fever. We confirmed this case by computerized tomography and pathologic examination after surgical resection. A brief review of the literature is presented.
Case Report ; Child, Preschool ; Cysts/*pathology/radiography/surgery ; Esophageal Cyst/*pathology/radiography/surgery ; Female ; Human ; Mediastinal Diseases/*pathology/radiography ; Trachea/*pathology/radiography/surgery

Radiological analysis of chest lesions detected on chest radiographs or CT scans begins with their classification into parenchymal, pleural, or extrapleural lesions according to their presumed origin. The mediastinum is divided anatomically into the anterior, middle, and posterior mediastinal compartments, and localizing a mediastinal mass to one of these divisions can locationfacilitate their differential diagnosis. A differential diagnosis of a mediastinal mass is usually based on a number of findings, including its ; the structure from which it is arising; whether it is single, multifocal (involving several different areas or lymph node groups), or diffuse; its size and shape; its attenuation (fatty, fluid, soft-tissue, or a combination of these); the presence of calcification along with its characteristics and amount; and its opacification following the administration of contrast agents.
Classification ; Contrast Media ; Diagnosis, Differential ; Lymph Nodes ; Mediastinal Diseases* ; Mediastinal Neoplasms ; Mediastinum ; Pleural Diseases ; Radiography, Thoracic ; Thorax ; Tomography, X-Ray Computed

OBJECTIVE: We observed patients in whom the fluid collection in the right lateral portion of the superior aortic recess on computed tomography (CT) scans mimicked a right anterior mediastinal mass on chest PA radiographs. The purpose of this study was to assess chest PA and CT features of these patients. MATERIALS AND METHODS: All chest PA radiographs and CT scans in 9 patients were reviewed by two radiologists on a consensus basis; for the presence of pleural effusion, pulmonary edema and heart size on chest PA radiographs. For the portion of the fluid collection in the superior aortic recess (SAR), a connection between the right lateral portion of the SAR (rSAR) and posterior portion of the SAR (pSAR) on CT scans, and the distance between the right lateral margin of the rSAR and the right lateral margin of the superior vena cava. RESULTS: Fluid collection in the rSAR on CT scans caused a right anterior mediastinal mass or a bulging contour on chest PA radiographs in all women patients. All patients showed cardiomegaly, five patients had pleural effusion, and two patients had mild pulmonary edema. Further, eight patients showed a connection between the rSAR and the pSAR. CONCLUSION: The characteristic features of these patients are the right anterior mediastinal mass-like opacity due to fluid collection in the rSAR, are bulging contour with a smooth margin and cardiomegaly regardless of pulmonary edema on the chest PA radiographs, and fluid connection between the rSAR and the pSAR on CT scans.
Aged ; Aged, 80 and over ; Aorta, Thoracic/*radiography ; Cardiomegaly/radiography ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Female ; Humans ; Mediastinal Diseases/*radiography ; Middle Aged ; Pleural Effusion/*radiography ; Pulmonary Edema/*radiography ; Radiography, Thoracic/*methods ; Retrospective Studies ; Tomography, X-Ray Computed/*methods

We report a very rare case of mediastinal tuberculosis in a 57-year old woman who presented with a large mediastinal cyst on chest radiography. She had a 10-year history of exertional dyspnea, but felt comfortable at a rest. A subsequent chest CT suggested a mediastinal cyst with mediastinal lymphadenopathy and communicating pericardial sac. She underwent a thoracotomy and excision of the mass, which was histologically revealed to be of tuberculous origin. Although rare, the apparent increase in the incidence of tuberculosis may result mediastinal cysts being diagnosed mediastinal tuberculosis. We also briefly review mediastinal lymphadenopathy due to tuberculosis.
Dyspnea ; Female ; Humans ; Incidence ; Lymphatic Diseases ; Mediastinal Cyst ; Middle Aged ; Pericardium* ; Radiography ; Thoracotomy ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis*

Castleman disease is a relatively rare disease, characterized by well-circumscribed benign lymph-node hyperplasia. The disease may develop anywhere in the lymphatic system, but is most commonly reported as unicentric Castleman disease in the mediastinum along the tracheobronchial tree. It is usually asymptomatic and detected on plain chest radiography as an incidental finding. We report an incidentally detected case of Castleman disease in the paravertebral space that was preoperatively diagnosed as a neurogenic tumor and treated by complete surgical resection.
Giant Lymph Node Hyperplasia ; Hyperplasia ; Incidental Findings ; Lymphatic System ; Mediastinal Neoplasms ; Mediastinum ; Radiography ; Rare Diseases ; Thorax ; Trees

OBJECTIVE: We wanted to determine whether the amount and shape of the anterior mediastinal fat in the patients suffering with usual interstitial pneumonia (UIP) or nonspecific interstitial pneumonia (NSIP) was different from those of the normal control group. MATERIALS AND METHODS: We selected patients who suffered with UIP (n = 26) and NSIP (n = 26) who had undergone CT scans. Twenty-six controls were selected from individuals with normal CT findings and normal pulmonary function tests. All three groups (n = 78) were individually matched for age and gender. The amounts of anterior mediastinal fat, and the retrosternal anteroposterior (AP) and transverse dimensions of the anterior mediastinal fat were compared by one-way analysis of variance and Bonferroni's test. The shapes of the anterior mediastinum were compared using the Chi-square test. Exact logistic regression analysis and polychotomous logistic regression analysis were employed to assess whether the patients with NSIP or UIP had a tendency to show a convex shape of their anterior mediastinal fat. RESULTS: The amount of anterior mediastinal fat was not different among the three groups (p = 0.175). For the UIP patients, the retrosternal AP dimension of the anterior mediastinal fat was shorter (p = 0.037) and the transverse dimension of the anterior mediastinal fat was longer (p = 0.001) than those of the normal control group. For the NSIP patients, only the transverse dimension was significantly longer than those of the normal control group (p < 0.001). The convex shape of the anterior mediastinum was predictive of NSIP (OR = 19.7, CI 3.32-infinity, p < 0.001) and UIP (OR = 24.42, CI 4.06-infinity, p < 0.001). CONCLUSION: For UIP patients, the retrosternal AP and transverse dimensions are different from those of normal individuals, whereas the amounts of anterior mediastinal fat are similar. UIP and NSIP patients have a tendency to have a convex shape of their anterior mediastinal fat.
Tomography, X-Ray Computed/*methods ; Radiographic Image Interpretation, Computer-Assisted/*methods ; Pulmonary Fibrosis/*radiography ; Middle Aged ; Mediastinal Diseases/*radiography ; Male ; Lung Diseases, Interstitial/*radiography ; Humans ; *Body Composition ; Aged ; Adult ; Adipose Tissue/*radiography

Percutaneous CT-guided needle biopsy of mediastinal and pulmonary lesions is a minimally invasive approach for obtaining tissue for histopathological examination. Although it is a widely accepted procedure with relatively few complications, precise planning and detailed knowledge of various aspects of the biopsy procedure is mandatory to avert complications. In this pictorial review, we reviewed important anatomical approaches, technical aspects of the procedure, and its associated complications.
Biopsy, Needle/instrumentation/*methods ; Contrast Media/diagnostic use ; Equipment Design ; Fluoroscopy ; Humans ; Lung Diseases/*pathology/radiography ; Mediastinal Diseases/*pathology/radiography ; Patient Positioning ; Radiography, Interventional/*methods ; Radiography, Thoracic/*methods ; *Tomography, X-Ray Computed