DDX of middle mediastinal mass

Accounting for 30% of mediastinal masses: (A + B)

Approach to DDX of middle mediastinal masses:

  • CT of the chest with contrast will help you to rapidly distinguish whether the mass you are seeing is due to:
    • Adenopathy from a bacterial or granulomatous infection or a neoplasm such as leukemia / lymphoma
    • Aneursym of one of the great vessels or heart
    • Bronchopulmonary foregut malformation. While esophageal duplication cyst and bronchogenic cyst are indistinguishable via imaging, pulmonary sequestration can be diagnosed if it has a feeding vessel arising from the aorta