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Malignant pulmonary and mediastinal tumors in children: differential diagnoses.

McCarville MB - Cancer Imaging (2010)

Bottom Line: Conventional chest radiography is the most common imaging procedure in children.Knowledge of the differential diagnostic possibilities for chest tumors in children is important for both the pediatric and general radiologist because they differ from adults.The more common pediatric, malignant, mediastinal and pulmonary tumors and the characteristic imaging and clinical features that are useful in distinguishing between them are discussed in this review.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.

ABSTRACT
Conventional chest radiography is the most common imaging procedure in children. When a chest mass is discovered, cross-sectional imaging is often required to accurately localize and characterize the lesion in order to narrow the differential diagnosis. Knowledge of the differential diagnostic possibilities for chest tumors in children is important for both the pediatric and general radiologist because they differ from adults. The more common pediatric, malignant, mediastinal and pulmonary tumors and the characteristic imaging and clinical features that are useful in distinguishing between them are discussed in this review.

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A 3-week-old boy with posterior mediastinal neuroblastoma. (A) Posterior-anterior chest radiograph shows a sharply circumscribed left paraspinal mass (arrows) initially thought to represent round pneumonia. (B) Axial CT image shows a solid mass (arrow) located in the posterior mediastinum with possible pleural involvement (curved arrow). (C) Coronal CT reconstruction shows the typical appearance of a posterior mediastinal neuroblastoma as a vertically elongated mass with tapered superior and inferior margins (arrows). (D) Axial T2-weighted MRI shows slight extension of tumor into a neural foramen (arrow).
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Figure 3: A 3-week-old boy with posterior mediastinal neuroblastoma. (A) Posterior-anterior chest radiograph shows a sharply circumscribed left paraspinal mass (arrows) initially thought to represent round pneumonia. (B) Axial CT image shows a solid mass (arrow) located in the posterior mediastinum with possible pleural involvement (curved arrow). (C) Coronal CT reconstruction shows the typical appearance of a posterior mediastinal neuroblastoma as a vertically elongated mass with tapered superior and inferior margins (arrows). (D) Axial T2-weighted MRI shows slight extension of tumor into a neural foramen (arrow).

Mentions: Approximately 90% of posterior mediastinal masses in children are of neurogenic origin[1,9]. These include ganglion cell tumors, nerve sheath and nerve tumors, and other nervous tissue tumors such as paragangliomas[3]. Most posterior mediastinal tumors in children are ganglion cell tumors. These tumors arise from sympathetic chain ganglia and form a spectrum of disease ranging from the most aggressive, neuroblastoma, to the less aggressive, ganglioneuroblastoma and benign ganglioneuroma[1]. Neuroblastoma occurs at a median age of 2 years, ganglioneuroblastoma at a median age of 5.5 years and ganglioneuroma usually occurs after 10 years of age. All three have similar radiologic features. On conventional radiography these tumors appear as a vertically elongated mass with tapered superior and inferior margins (Fig. 3). The lateral margin is usually smooth and convex. About 30% contain calcification. Bone changes include spreading and erosion of ribs and widening of neural foramina[3].Figure 3


Malignant pulmonary and mediastinal tumors in children: differential diagnoses.

McCarville MB - Cancer Imaging (2010)

A 3-week-old boy with posterior mediastinal neuroblastoma. (A) Posterior-anterior chest radiograph shows a sharply circumscribed left paraspinal mass (arrows) initially thought to represent round pneumonia. (B) Axial CT image shows a solid mass (arrow) located in the posterior mediastinum with possible pleural involvement (curved arrow). (C) Coronal CT reconstruction shows the typical appearance of a posterior mediastinal neuroblastoma as a vertically elongated mass with tapered superior and inferior margins (arrows). (D) Axial T2-weighted MRI shows slight extension of tumor into a neural foramen (arrow).
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC2967153&req=5

Figure 3: A 3-week-old boy with posterior mediastinal neuroblastoma. (A) Posterior-anterior chest radiograph shows a sharply circumscribed left paraspinal mass (arrows) initially thought to represent round pneumonia. (B) Axial CT image shows a solid mass (arrow) located in the posterior mediastinum with possible pleural involvement (curved arrow). (C) Coronal CT reconstruction shows the typical appearance of a posterior mediastinal neuroblastoma as a vertically elongated mass with tapered superior and inferior margins (arrows). (D) Axial T2-weighted MRI shows slight extension of tumor into a neural foramen (arrow).
Mentions: Approximately 90% of posterior mediastinal masses in children are of neurogenic origin[1,9]. These include ganglion cell tumors, nerve sheath and nerve tumors, and other nervous tissue tumors such as paragangliomas[3]. Most posterior mediastinal tumors in children are ganglion cell tumors. These tumors arise from sympathetic chain ganglia and form a spectrum of disease ranging from the most aggressive, neuroblastoma, to the less aggressive, ganglioneuroblastoma and benign ganglioneuroma[1]. Neuroblastoma occurs at a median age of 2 years, ganglioneuroblastoma at a median age of 5.5 years and ganglioneuroma usually occurs after 10 years of age. All three have similar radiologic features. On conventional radiography these tumors appear as a vertically elongated mass with tapered superior and inferior margins (Fig. 3). The lateral margin is usually smooth and convex. About 30% contain calcification. Bone changes include spreading and erosion of ribs and widening of neural foramina[3].Figure 3

Bottom Line: Conventional chest radiography is the most common imaging procedure in children.Knowledge of the differential diagnostic possibilities for chest tumors in children is important for both the pediatric and general radiologist because they differ from adults.The more common pediatric, malignant, mediastinal and pulmonary tumors and the characteristic imaging and clinical features that are useful in distinguishing between them are discussed in this review.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.

ABSTRACT
Conventional chest radiography is the most common imaging procedure in children. When a chest mass is discovered, cross-sectional imaging is often required to accurately localize and characterize the lesion in order to narrow the differential diagnosis. Knowledge of the differential diagnostic possibilities for chest tumors in children is important for both the pediatric and general radiologist because they differ from adults. The more common pediatric, malignant, mediastinal and pulmonary tumors and the characteristic imaging and clinical features that are useful in distinguishing between them are discussed in this review.

Show MeSH
Related in: MedlinePlus