Vascular Lesions of the Mediastinum

Vascular lesions represent approximately 10% of mediastinal masses detected on chest radiography. The most common lesions include abnormalities of the systemic arteries and veins, pulmonary arteries and veins, and thoracic aorta. Benign neoplasms such as hemangiomas and lymphangiomas are rare. Vascular abnormalities may be congenital or acquired, and the former may be associated with congenital heart disease in the pediatric population. Most acquired lesions are degenerative, post-traumatic, or neoplastic. Vascular lesions of the mediastinum may be detected on chest radiography as loss of normal mediastinal contours, focal opacities, or thickening of lines and stripes. These abnormalities are best evaluated with cross-sectional imaging such as contrast-enhanced computed tomography (CT) or CT angiography (CTA).