Jeung Mi-Young, Gasser Bernard, Gangi Afshin, Bogorin Adriana, Charneau Dominique, Wihlm Jean Marie, Dietemann Jean-Louis, Roy Catherine
Department of Radiology B, University Hospital of Strasbourg, 1 place de l'Hôpital, 67091 Strasbourg, France.
Radiographics. 2002 Oct;22 Spec No:S79-93. doi: 10.1148/radiographics.22.suppl_1.g02oc09s79.
Cystic masses of the mediastinum are well-marginated round lesions that contain fluid and are lined with epithelium. Major cystic masses include congenital benign cysts (ie, bronchogenic, esophageal duplication, neurenteric, pericardial, and thymic cysts), meningocele, mature cystic teratoma, and lymphangioma. Many tumors (eg, thymomas, Hodgkin disease, germ cell tumors, mediastinal carcinomas, metastases to lymph nodes, nerve root tumors) can undergo cystic degeneration-especially after radiation therapy or chemotherapy-and demonstrate mixed solid and cystic elements at computed tomography (CT) or magnetic resonance (MR) imaging. If degeneration is extensive, such tumors may be virtually indistinguishable from congenital cysts. A mediastinal abscess or pancreatic pseudocyst also appears as a fluid-containing mediastinal cystic mass. However, clinical history and manifestations, anatomic position, and certain details seen at CT or MR imaging allow correct diagnosis in many cases. Familiarity with the radiologic features of mediastinal cystic masses facilitates accurate diagnosis, differentiation from other cystlike lesions, and, thus, optimal patient treatment.
纵隔囊性肿块是边界清晰的圆形病变，内含液体，内衬上皮。主要的囊性肿块包括先天性良性囊肿（如支气管源性囊肿、食管重复囊肿、神经肠源性囊肿、心包囊肿和胸腺囊肿）、脊膜膨出、成熟囊性畸胎瘤和淋巴管瘤。许多肿瘤（如胸腺瘤、霍奇金病、生殖细胞肿瘤、纵隔癌、淋巴结转移瘤、神经根肿瘤）可发生囊性退变，尤其是在放疗或化疗后，在计算机断层扫描（CT）或磁共振（MR）成像上表现为实性和囊性成分混合。如果退变广泛，此类肿瘤可能与先天性囊肿几乎无法区分。纵隔脓肿或胰腺假性囊肿也表现为含液的纵隔囊性肿块。然而，临床病史和表现、解剖位置以及CT或MR成像上看到的某些细节在许多情况下可实现正确诊断。熟悉纵隔囊性肿块的放射学特征有助于准确诊断、与其他囊肿样病变鉴别，从而实现对患者的最佳治疗。
