EVALUATION OF MEDIASTINAL MASS LESIONS USING COMPUTED TOMOGRAPHY AND CORRELATION WITH HISTOPATHOLOGICAL DIAGNOSIS

Abstract

Introduction: The studies are not limited to xrays only in this modern radiological era. Since xrays have their own limitations, CT study has made things easier and handy. CT is very much useful in detailing the pathologies of mediastinal lesions. The advent of contrast in CT revelutionizes the evaluation of Mediastinal pathologies. CT also helps in studying in characteristics and nature of masses with involvement of adjacent structures. Additional role of CT scan is to take biopsy of mass lesions and then correlate the CT diagnosis with histopathological diagnosis

Material and methods:All the Patients referred in dept of radiodiagnosis, govt medical college and new civil hospital, Surat for clinically suspected mediastinal pathologies and suspected mediastinal lesions on chest X-ray undergone plane or contrast enhanced computed tomography scan (CECT) or both after proper counselling about the procedure and after taking the written consent. Prospective study of all 40 patients done from October 2017 to august 2018 and CT findings were correlated with histopathological diagnosis.

Results: In our study, anterior mediastinum was the most commonly involved compartment, followed by superior mediastinum, posterior mediastinum and middle mediastinum. Lymphoma and thymic lesions are most common lesions in anterior and superior mediastinum. Teratoma and metastatic lymphadenopathy in middle mediastinum and neurogenic tumour like schwannoma in posterior mediastinum. Out of 38 patients who undergone biopsy, histopathology report of 35 patients indicates same diagnosis as indicated by CECT (diagnostic accuracy 87.5%).

Conclusion: From the above results, we conclude that computed tomography definitely has a major role to play in evaluation of a mediastinal mass regarding the compartmental distribution, mass effect and provisional diagnosis which was correlated with histopathological diagnosis.