Mediastinal shadow

Introduction Mediastinal inflammation can be divided into acute suppurative infection and chronic fibrotic lesions. The former has acute infection symptoms, which can cause various symptoms of superior vena cava compression syndrome or other organs in the mediastinum. The X-ray showed a widening of the mediastinal shadows on both sides, and the above mediastinum was obvious. The inflammation of the surrounding pleura caused the contours on both sides to be blurred. The lateral chest radiograph has an increased density behind the sternum. The outline of the trachea and aortic arch is blurred. An abscess is formed, and a prominent arc shadow can be seen on one side or both sides of the mediastinum, and the trachea and esophagus are displaced by pressure. There may also be signs of mediastinal emphysema, abscess and fluid level, pleural effusion, and liquid pneumothorax. Esophageal lipiodol or organic iodine imaging can confirm the perforation of the esophagus, esophageal bronchospasm or esophageal pleural palsy. Computed tomography can detect early mediastinal inflammation caused by severe deep neck infection.

Cause

The cause of chronic mediastinal inflammation is more complicated. It has been known that tuberculosis, physio-organisms, actinomycetes, sarcoidosis, silicosis, post-traumatic mediastinal hemorrhage, and drug poisoning can cause mediastinal fibrosis. It may also be related to autoimmunity. The cause of some patients is unknown.

an examination

Related inspection

Thoracic plain chest CT examination of chest disease signs

Laboratory inspection:

The erythrocyte sedimentation rate is normal.

Other auxiliary inspections:

X-ray examination showed no abnormal findings, but most patients had a thickening of the mediastinal pleura or a widening of the upper mediastinum, and calcified shadows were seen in the lesion. Stomach and duodenal barium meal examination showed esophageal stricture. The tomography showed tracheal and bronchial stenosis. Angiography helps to understand the obstruction of the superior vena cava and its branches. CT examinations also have diagnostic value.

Differential diagnosis

This disease should pay attention to the identification of malignant mediastinal tumors. It is difficult to be confused in the early stage when the tumor is obvious. Mediastinal tumors are a group of tumors originating from the mediastinum, including thymoma, intrathoracic goiter, bronchial cysts, dermoid cysts, teratomas, lymphosarcoma, malignant lymphoma, pericardial cysts, lipomas, neurogenic tumors, esophagus Cysts, etc., mostly benign.

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