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. 2020 Apr;15(4):568-579.
doi: 10.1016/j.jtho.2019.12.108. Epub 2019 Dec 20.

Distribution of Mediastinal Lesions Across Multi-Institutional, International, Radiology Databases

Anja C Roden  1 , Wentao Fang  2 , Yan Shen  3 , Brett W Carter  4 , Darin B White  5 , Sarah M Jenkins  6 , Grant M Spears  6 , Julian R Molina  7 , Eyal Klang  8 , Mattia D Segni  8 , Jeanne B Ackman  9 , Edward Z Sanchez  9 , Nicolas Girard  10 , Engjellush Shumeri  10 , Marie-Pierre Revel  11 , Guillaume Chassagnon  11 , Ami Rubinowitz  12 , Demetrius Dicks  12 , Frank Detterbeck  13 , Jane P Ko  14 , Conrad B Falkson  15 , Samantha Sigurdson  15 , Sabrina Segreto  16 , Silvana Del Vecchio  16 , Giovanella Palmieri  17 , Margaret Ottaviano  17 , Mirella Marino  18 , Robert Korst  19 , Edith M Marom  8
Affiliations
Free article

Distribution of Mediastinal Lesions Across Multi-Institutional, International, Radiology Databases

Anja C Roden et al. J Thorac Oncol. 2020 Apr.
Free article

Abstract

Introduction: Mediastinal lesions are uncommon; studies on their distribution are, in general, small and from a single institution. Furthermore, these studies are usually based on pathology or surgical databases and, therefore, miss many lesions that did not undergo biopsy or resection. Our aim was to identify the distribution of lesions in the mediastinum in a large international, multi-institutional cohort.

Methods: At each participating institution, a standardized retrospective radiology database search was performed for interpretations of computed tomography, positron emission tomography-computed tomography, and magnetic resonance imaging scans including any of the following terms: "mediastinal nodule," "mediastinal lesion," "mediastinal mass," or "mediastinal abnormality" (2011-2014). Standardized data were collected. Statistical analysis was performed.

Results: Among 3308 cases, thymomas (27.8%), benign mediastinal cysts (20.0%), and lymphomas (16.1%) were most common. The distribution of lesions varied among mediastinal compartments; thymomas (38.3%), benign cysts (16.8%), and neurogenic tumors (53.9%) were the most common lesions in the prevascular, visceral, and paravertebral mediastinum, respectively (p < 0.001). Mediastinal compartment was associated with age; patients with paravertebral lesions were the youngest (p < 0.0001). Mediastinal lesions differed by continent or country, with benign cysts being the most common mediastinal lesions in the People's Republic of China, thymomas in Europe, and lymphomas in North America and Israel (p < 0.001). Benign cysts, thymic carcinomas, and metastases were more often seen in larger hospitals, whereas lymphomas and thymic hyperplasia occurred more often in smaller hospitals (p < 0.01).

Conclusions: Our study confirmed that the spectrum and frequency of mediastinal lesions depend on mediastinal compartment and age. This information provides helpful demographic data and is important when considering the differential diagnosis of a mediastinal lesion.

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