Hodgkin Lymphoma (HL) and Non Hodgkins Lymphoma (NHL) can present with lymphadenopathy and or a mediastinal mass.
Also sometimes patients have systemic symptoms (B symptoms) of fevers, weight loss and night sweats.
Anterior Mediastinal Mass
Anterior mediastinum contains the thymus, heart, pericardium and anterior mediastinal lymph nodes.
This is the commonest site for a mediastinal tumor.
The chest X-ray below shows a massive anterior mediastinal mass secondary to acute lymphoblastic leukemia (#1).
It is possible to tell this is anterior by looking at the lateral film - #2 points to an area where there is complete filling of the retrosternal space by the mass.
Table : Differential Diagnosis of an anterior mediastinal mass
Congenital vs Acquired
Biggest in children at 10yrs. Texture looks different from lymphoma on CT
|Infection||Bacterial - TB & atypical mycobacterium|
|Bacterial - staphylococcal|
|Langerhans cell Histiocytosis|
Non Hodgkin Lymphoma
(Tcell lymphoblastic lymphoma commonest)
|T cell Acute lymphoblastic leukemia|
|Malignant germ cell tumors|