Sometimes chest pains are perceived as a cardiovascular problem or associated with another disease. Tumors of the mediastinum due to their localization are not immediately noticeable. Often, the survival of a patient depends on early detection of pathology.
Definition of
The formations that arise in the zone of mediastinum form a large group of tumors. They originate in different types of cells, differ in morphological terms.
The space, called mediastinum, is located between four conventionally designated boundaries:
- sternum( on its inner side) - in front,
- with thoracic spine with all structural elements( viewed from the inside) - behind,
- pleura that lining the boundary layer on the sides;
- conditional plane, which lies horizontally and passes above the roots of the lungs - the upper boundary;
- pleura that is lined on the diaphragm - the lower boundary.
Classification of
Mediastinal tumors are more often benign in nature, oncological formations of different morphology occupy 20 ÷ 40%. Tumor formations develop from tissue cells:
- that originated in the mediastinum as a result of a pathological process that occurred in the perinatal period;
- organs in the mediastinum region,
- that are located between the organs.
Neurogenic formations
A third of the formations in the mediastinum region are neurogenic tumors. In the pathology of nerve cells occur:
- chemodectomy,
- sympatognomy,
- paragangliomas,
- ganglioneuromas.
Nerve sheath disease can initiate the appearance of formations:
- neurofibromas,
- neurogenic sarcomas,
- neurinomas.
Mesenchymal
Education occupies a quarter of all mediastinal tumors. Here the formations arising in soft tissues with different morphology are united. This:
- angiosarcoma,
- lipoma,
- lymphangioma,
- fibrosarcoma,
- hemangioma,
- leiomyoma.
Dysambriogenetic
Pathology arises from three elements of the embryonic leaflet. Half of all cases of neoplasms are benign in nature.
This type of pathology includes:
- seminoma,
- intrathoracic goiter,
- chorionepithelioma,
- teratoma.
Neoplasms of thymus gland
In the total number of mediastinal pathologies, tumors associated with the thymus gland are a relatively rare phenomenon. Of these, only five percent are classified as cancers.
Diagnosis can reveal:
- thymoma,
- adenocarcinoma,
- squamous cell carcinoma,
- mucoepidermoid carcinoma.
Lymphoid
This type of pathology affects directly the lymphoid tissue or lymph nodes. It is considered as a disease of the immune system.
This:
- lymphosarcoma,
- reticulosarcoma,
- lymphogranulomatosis.
Pseudotumors
These include this kind of problems that resemble tumors, but they are not:
- vascular aneurysms,
- enlarged lymph nodes.
True brushes
These are hollow formations, can be acquired or congenital. These include:
- echinococcal cysts,
- coelomic cysts of the pericardium,
- bronchogenic cysts,
- enterogenic cysts.
Distinguish in the same way:
- primary formations - pathologies that have arisen in tissues that are located in the zone of mediastinum;
- secondary tumors - appeared as a result of metastasis from organs that are outside the mediastinum.
Risk factors and location of
The causes of tumors of the upper and posterior mediastinum arise for the following reasons:
- smoking, and the degree of harm increases with the length of time and number of cigarettes smoked per day;
- with age, the protective functions of the body are reduced, it is important to lead a healthy lifestyle;
- there are many environmental influences that can cause cell mutation:
- ionizing radiation,
- contact with harmful chemicals,
- action of radon in confined spaces,
- household dust or on production,
- adverse ecology in residence,
- stressful situations,
- improper nutrition.
The mediastinum region is conventionally divided into floors:
- upper,
- middle,
- lower.
Also the area of the mediastinum is divided conventionally by vertical planes into departments:
- front,
- middle,
- rear.
Accordingly, tumors that occur in specific departments correspond to the pathology of organs and tissues between them located in these zones.
Front of
Tumors of anterior mediastinum:
- teratomas,
- mesenchymal tumors,
- lymphomas,
- thymomas.
Top
The mediastinum top formulations:
- is a congested goiter,
- of lymphoma,
- of thymoma.
Rear
Tumors of the back of the mediastinum, can be:
- neurogenic tumors,
- enterogenic cysts.
Symptoms of mediastinal tumors
The onset of the disease often occurs without giving any tangible signals. Since the pathologies of the mediastinum are of different nature, the signs of the disease of each species differ from each other.
Symptoms that occur most frequently:
- asthenic syndrome manifests through signs:
- fatigue,
- may increase temperature,
- general malaise,
- with nerve disease, pain,
- myasthenia syndrome causes muscle weakness of some group;the patient is difficult, for example:
- turn the head,
- raise the arm,
- open the eyes,
- if the upper hollow vein is squeezed:
- headache,
- dilated veins,
- dyspnea,
- neck and facial swelling,
- cyanosis of the lips,
- if the formationcauses squeezing of the organs that are in the mediastinum zone:
- cough,
- dyspnea,
- hemoptysis.
Diagnostic methods
When examining a patient, a specialist in his complaints may assign an instrumental examination.
- One of the main ways to diagnose a patient with suspicion of a tumor in the mediastinum zone is an x-ray study. This method includes:
- fluorography,
- fluoroscopy
- and other methods.
The study provides information on how the tumor is located in space, its size and influence on neighboring tissues.
- Thoracoscopy allows you to view some types of formations and take material for biopsy.
- Magnetic resonance imaging provides the most detailed information about soft tissues. The method provides an opportunity to obtain all the data necessary for the physician about pathology.
- Mediastinoscopy - allows you to see the condition of some lymph nodes, while taking material for biopsy.
Treatment of
The most favorable treatment for mediastinal tumors is to detect pathology in time and remove. This refers to examples where the nature of education is malignant and in the case of a benign tumor. Methods of treatment of mediastinal tumors in children and adult patients do not differ.
Operation
A non-cancerous tumor may reoccur with time, so early surgery can prevent a negative development scenario.
Applied:
- Closed method - thoracoscopic. This method is referred to as endoscopic interventions. It is safe and low traumatic, video surveillance is provided. In a thoracoscopic way, some types of tumors can be removed.
- Open method: The
method is used in complex cases where it is not possible to do a closed operation.
Chemotherapy
In the malignant nature of education, chemotherapy is mandatory. Choose drugs that are able to kill the cells of the tumor, which is identified in the diagnosis.
The procedure for prescribing a specialist can be performed:
- before surgery to reduce formation;
- after it to disable the viability of cancer cells that remained after the operation;
- by a separate method, when the intervention is impossible.
Chemotherapy, which is performed without surgery, can support the patient's condition, but not cure completely.
Radiotherapy
Used in the same way as the previous method, being an auxiliary tool in the periods before and after surgery. It can be an independent procedure if the operation is not shown for the patient's condition or the degree of development of the pathology.
Forecast
The hope for a favorable outcome of mediastinal tumors in different cases is ambiguous.
Depends on the result of treatment:
- on the size of the formation,
- localization,
- tumor maturity,
- whether it began to spread to the tissues of other organs,
- , whether metastases have appeared,
- is patient or not.
The best option - early detection of the tumor and complete removal of it.
Video about modern surgical technologies in the treatment of malignant tumors of the mediastinum: