Differential diagnosis of major middle mediastinal lesions

Differential diagnosis of major middle mediastinal lesions

In the following list, an asterisk (*) indicates the most common causes:

  • • Goiter
  • • Lymphadenopathy
  • • Metastatic disease* (lung cancer is the most common etiologic factor)
  • • Lymphoma (non-Hodgkin lymphoma and Hodgkin lymphoma) or leukemia*
  • • Granulomatous infection (fungus, tuberculosis, nontuberculous mycobacterium)
  • • Sarcoidosis
  • • Inhalational lung disease (silicosis, coal workers’ pneumoconiosis, or berylliosis)
  • • Castleman disease
  • • Aortic abnormalities: aneurysm,* dissection,* traumatic aortic rupture
  • • Bronchopulmonary foregut cysts
  • • Tracheal tumor
  • • Esophageal abnormalities: neoplasms (carcinoma, leiomyoma, leiomyosarcoma), achalasia
  • • Hiatal hernia* (often contains air-fluid level) 
  • • Cardiac tumor
  • • Left ventricular or thoracic aortic aneurysm or pseudoaneurysm
  • • Pulmonary artery aneurysm
  • • Neurogenic tumor of the vagus nerve
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