A diagnostic approach to mediastinal masses in clinical practice.

Mediastinal masses represent a heterogeneous group of entities characterized by a variety of histopathological and radiological features. Imaging plays a pivotal role in the detection and interpretation of mediastinal abnormalities. CT remains the modality of choice due to its high spatial and temporal resolution and its ability to assess tissue composition, including the detection of fluid, fat, and calcifications. MRI represents a complementary tool in specific scenarios, such as differentiating complicated cysts from solid lesions or identifying intracellular fat content, as seen in thymic hyperplasia. The differential diagnosis of mediastinal masses relies primarily on the location of the mass and tissue composition, integrated with clinical characteristics of the patient. This review discusses the most common mediastinal masses in adults, providing a practical approach to their differentiation mainly based on the predominant density pattern and location.