CHEE-94
Beyond 5Ts: Pearls and Pitfalls in Diagnosis of Anterior Mediastinal Masses
Sunday, Nov. 27 8:00AM – 9:00AM Room: Learning Center – CH
Participants
Tetsuro Araki, MD, PhD, Philadelphia, PA (Presenter) Nothing to Disclose
TEACHING POINTS
1. To understand appropriate image modalities for anterior mediastinal masses (AMM).
2. To understand common differential diagnosis of AMM.
3. To understand key image finding in differential diagnoses of AMM.
TABLE OF CONTENTS/OUTLINE
1. Appropriate selection of image modalities for AMM a. Role of chest radiograph, CT, and MRI b. Additional imaging options (Dual-energy CT, PET/CT, SPECT)
2. Anatomy of mediastinum a. Mediastinal compartment suggested by Felson b. Cross sectional mediastinal compartment suggested by ITMIG c. Common lesions in each compartment
3. Review of 5Ts a. Thymic epithelial tumors: Top of differential of AMM? b. Thyroid tumor: Is MRI helpful? c. Teratoma: Macroscopic fat, when it’s malignant? d. Terrible lymphoma: Why terrible? e. Thoracic aorta: not neoplastic, though f. Are 5Ts common as AMM?
4. Beyond 5Ts: More practical DD of AMM than 5Ts a. Lymph nodes b. Benign mediastinal lesions (Thymic cyst/pericardial cyst) • Unilocular vs multilocular thymic cyst • Morgagni hernia c. Normal/hyperplastic thymus • Normal morphology of thymus • What is “normal” thymus for age and sex • True vs lymphoid hyperplasia d. Ectopic thyroid lesion
5. Key image features useful in differential a. CT density and MRI signal density on T1 and T2WI b. Solid vs cystic c. Microscopic and macroscopic fat d. Detection of calcification e. Diffusion weighted images/ADC map f. FDG uptake on PET/CT g. Iodine and fat quantification on DE-CT
6. Summary
