Mediastinal abnormalities

The mediastinum is the area within the centre of the chest containing the heart, great vessels, nerves, lymph nodes, trachea, oesophagus, and thymus. Two-thirds of mediastinal masses are benign. These abnormalities tend to occure between the ages of 20–40 years; presence of symptoms and anterior location of a mass are all associated with an increased likelihood of malignancy. Common symptoms of mediastinal disease include cough, chest pain, and dyspnoea, as well as symptoms relating to any structure being compressed or disrupted such as dysphagia, stridor, SVCO or Horner’s syndrome. Systemic effects (night sweats, weight loss in lymphoma) and paraneoplastic effects (e.g. myasthenia with thymoma) may be seen. Mediastinal disorders can also be asymptomatic.