Histopathological Study and Immunohistochemistry of Mediastinal Masses of Anterior Compartment
AbstractBackground: The mediastinum is the mid portion of the thoracic cavity, further divided into the anterior, middle, and posterior mediastinum. The numerous organs within the mediastinum make it prone to the development of various lesions. About half of all mediastinal masses occur in the anterior compartment. The most common are thymoma, lymphoma and mature teratoma. An accurate histopathological diagnosis is required for the management of mediastinal lesions. Methods: This is a 2-year prospective study conducted in the Department of Pathology on Biopsies and Resected Specimens of Anterior Mediastinal Masses (AMM) in a tertiary care hospital from September2020-September2022. Sections were studied after staining with hematoxylin and eosin(H&E). Immunohistochemical (IHC) stains were done wherever required. Result: The present study included 58 cases of AMM. The age of the patients ranged from 2-77 years. Males constituted 68.90 % of cases. The male-to-female ratio was 5:2.2. Cough was the most common presenting symptom. Thymic pathology was detected in 56.8% of cases, of which thymoma is the most common. Thymoma presented with Myasthenia Gravis (M.G.) in 2 cases. Lymphoma constituted 12% of cases. Metastatic carcinoma in 12%, Extragonadal Germ Cell Tumor (EGCT) in 8.6% and lymphangioma in 3.4% cases. Lipoma, sarcoidosis and myofibroblastic tumor each constitute 1.72% cases. Conclusion: The present study describes the various lesions of the anterior compartment.
Almeida TP, Heller D. Anterior Mediastinal Mass. Stat Pearls. 2022;1-10
kanasagara D, Shah D. Histopathological study of mediastinal lesion in a medical college-3 years study. Int J Clin Diagn Pathol. 2019;2(1):18-21.
Dasgupta S, Bose D, Bhattacharyya N, Saha M, Biswas K, Biswas P. A clinicopathological study of mediastinal masses operated in a tertiary care hospital in Eastern India in 3 years with special reference to thymoma. Indian J of Pathol and Microbiol. 2016;59(0):20-24.
Sundaram S, Vidhyalakshmi S. Histomorphological Spectrum of Mediastinal Masses with Special Emphasis on Rare Lesions. Journal of clinical and diagnostic research. 2020;14(8):01-05.
Aggarwal R, Rao S, Chopra P, Bhalla S, Vijay CL, Asaf B.B. et al. Morphological spectrum of mediastinal lesions with special emphasis on evaluation of needle biopsy: An experience from a tertiary care hospital. Indian J Med Res. 2016;144(4):544-551.
Shamsuddin F, Khadilkar U, Saha D, Sreedharan S. A clinicopathologic study of mediastinal lesions with special emphasis on thymomas. Int J Res Med Sci. 2015;3(8):1902-1910.
Totanarungroj K, Watcharaporn C, Muangman N. Helpful CT findings for giving specific diagnosis of anterior mediastinal tumors. J Med Assoc Thai. 2010;93(4):489-96.
Weissferdt A, Moran CA. Immunohistochemistry in the diagnosis of thymic epithelial neoplasms. Appl Immunohistochem Mol Morphol. 2014;22(7):479-87.
Sharma P, Jha V, Kumar N, Kumar R, Mandal A. Clinicopathological Analysis of Mediastinal Masses: A Mixed Bag of Non-Neoplastic and Neoplastic Etiologies. Turk Patoloji Derg. 2017;33(1):37-46.
Agrawal M, Uppin MS, Uppin SG, Challa S, Agrawal S, Dharmrakshak AK. Thymoma diagnosis and categorization in the current scenario: Morphological analysis based on interobserver variability. Ann Thorac Med. 2020;15(2):90-94.
S D, Raju S, Augustine J, Kumar A. Clinico-Pathological Analysis of Thymic Epithelial Tumours: An Institutional Study. Annals pathol. lab. med. 2018;5(11):923-927.
Aggarwal R, Rao S, Dhawan S, Bhalla S, Kumar A, Chopra P. Primary mediastinal lymphomas, their morphological features and comparative evaluation. Lung India. 2017;34(1):19-24.
Nasit JG, Patel M, Parikh B, Shah M, Davara K. Anterior mediastinal masses: A study of 50 cases by fine needle aspiration cytology and core needle biopsy as a diagnostic procedure. South Asian J Cancer. 2013;2(1):7-13.
Piris M, Medeiros L, Chang K. Hodgkin lymphoma: a review of pathological features and recent advances in pathogenesis. Pathology. 2020;52(1):154-165.
No T.H., Seol SH, Seo GW, Kim DI, Yang SY, Jeong CH, et al. Benign Mature Teratoma in Anterior Mediastinum. J Clin Med Res. 2015;7(9):726-728.
Chaudry G, Phillips M. Mediastinal malignant germinoma. Eurorad.2003.
Yamashita T, Watahiki M, Asai K. Mediastinal Metastasis of Breast Cancer Mimicking a Primary Mediastinal Tumor. Am J Case Rep. 2020;21:1-6.
Nishihira M, Ito Y, Araki O, Karube Y, Seki N, Tamura M, et al. Spindle Cell Sarcoma Originated in the Anterior Mediastinum; Report of a Case. The Japanese journal of thoracic surgery. 2016; 69(7):556-9.
19.Gupta P, Bagarhatta M, Mendiratta K. Malignant Spindle Cell Sarcoma.Eurorad.2022.
Gupta A, Palkar A, Narwal P, Kataria A. Mediastinal lipoma as a cause of dyspnea. Respir Med Case Rep. 2019;27:100828.
Fokkema J, Paul M, Vrouenraets B. Mediastinal lymphangioma in an adult. Ann R Coll Surg of Engl. 2014;96(5): 24-25.
Sugiyama K, Nakajima Y. Inflammatory myofibroblastic tumor in the mediastinum mimicking a malignant tumor. Diagn Interv Radiol. 2008;14(4):197-199.
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