Uneingeschränkter Zugang

Transcutaneous B-mode ultrasound (TUS) and contrast-enhanced ultrasound (CEUS) pattern of mediastinal tumors: a pictorial essay

Ehsan Safai Zadeh
Ehsan Safai Zadeh
, 
Christoph Frank Dietrich
Christoph Frank Dietrich
, 
Corinna Trenker
Corinna Trenker
, 
Amjad Alhayri
Amjad Alhayri
 und 
Christian Görg
Christian Görg
   | 15. Dez. 2021
Journal of Ultrasonography's Cover Image
Über diesen Artikel
Vorheriger Artikel
Nächster Artikel
Zitieren
Article Category: research-article
Online veröffentlicht: 15. Dez. 2021
Seitenbereich: 340 - 347
Eingereicht: 17. Mai 2021
Akzeptiert: 02. Juli 2021
DOI: https://doi.org/10.15557/jou.2021.0056
Schlüsselwörter
© 2021 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o.
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Fig. 1.

A 40-year-old female patient with mediastinal tumor in the anterior mediastinum as an incidental finding in computed tomography (A). Thoracic ultrasound indicated anechoic nodes (B), which showed no enhancement on contrast-enhanced ultrasound (C). Mediastinoscopy was performed, and regressive thymoma was histologically confirmed
A 40-year-old female patient with mediastinal tumor in the anterior mediastinum as an incidental finding in computed tomography (A). Thoracic ultrasound indicated anechoic nodes (B), which showed no enhancement on contrast-enhanced ultrasound (C). Mediastinoscopy was performed, and regressive thymoma was histologically confirmed

Fig. 2.

A 64-year-old female patient with a mediastinal tumor in the anterior mediastinum as an incidental finding on computed tomography (A). Thoracic ultrasound indicated a polyseptated anechoic tumor (B), which showed enhancement of cyst membranes on contrast-enhanced ultrasound (C). Surgical resection was performed. A cystic mediastinal tumor with involved thymus parts was resected. Multilocular cystic hamartoma was histologically confirmed
A 64-year-old female patient with a mediastinal tumor in the anterior mediastinum as an incidental finding on computed tomography (A). Thoracic ultrasound indicated a polyseptated anechoic tumor (B), which showed enhancement of cyst membranes on contrast-enhanced ultrasound (C). Surgical resection was performed. A cystic mediastinal tumor with involved thymus parts was resected. Multilocular cystic hamartoma was histologically confirmed

Fig. 3.

A 75-year-old female patient with mediastinal tumor in the anterior mediastinum as an incidental finding on computed tomography (A). Thoracic ultrasound indicated a hypoechoic inhomogeneous tumor (arrows) (B), which showed marked enhancement on contrast-enhanced ultrasound (C). A mediastinal thyroid gland was diagnosed by scintigraphy
A 75-year-old female patient with mediastinal tumor in the anterior mediastinum as an incidental finding on computed tomography (A). Thoracic ultrasound indicated a hypoechoic inhomogeneous tumor (arrows) (B), which showed marked enhancement on contrast-enhanced ultrasound (C). A mediastinal thyroid gland was diagnosed by scintigraphy

Fig. 4.

A 43-year-old female patient admitted for ultrasound-guided biopsy due to mediastinal tumor (arrow) in the anterior mediastinum as an incidental finding on computed tomography after an intensive care stay (A). Thoracic ultrasound indicated a complex hypoechoic tumor (B), which showed no enhancement on contrast-enhanced ultrasound, as in hematoma (H) (C). A biopsy was not performed due to anamnestic central venous catheter. The tumor showed spontaneous regression
A 43-year-old female patient admitted for ultrasound-guided biopsy due to mediastinal tumor (arrow) in the anterior mediastinum as an incidental finding on computed tomography after an intensive care stay (A). Thoracic ultrasound indicated a complex hypoechoic tumor (B), which showed no enhancement on contrast-enhanced ultrasound, as in hematoma (H) (C). A biopsy was not performed due to anamnestic central venous catheter. The tumor showed spontaneous regression

Fig. 5.

A 24-year-old male patient with dyspnea and mediastinal tumor (arrow) in the anterior mediastinum as an incidental finding on computed tomography, admitted for ultrasound-guided biopsy (A). Thoracic ultrasound indicated an inhomogeneous, hypoechoic mass (B). On contrast-enhanced ultrasound, large areas showed no enhancement with motion artifacts in real-time examination, as in abscess (A) (C). Ultrasound-guided biopsy was performed. Histologically, granulomatous necrotizing lymphadenitis was found, consistent with lymph node tuberculosis
A 24-year-old male patient with dyspnea and mediastinal tumor (arrow) in the anterior mediastinum as an incidental finding on computed tomography, admitted for ultrasound-guided biopsy (A). Thoracic ultrasound indicated an inhomogeneous, hypoechoic mass (B). On contrast-enhanced ultrasound, large areas showed no enhancement with motion artifacts in real-time examination, as in abscess (A) (C). Ultrasound-guided biopsy was performed. Histologically, granulomatous necrotizing lymphadenitis was found, consistent with lymph node tuberculosis

Fig. 6.

A 40-year-old female patient with B-symptoms and mediastinal tumor in the anterior mediastinum on computed tomography (A). Thoracic ultrasound indicated a complex hypoechoic tumor (B), which on contrast-enhanced ultrasound showed hyperenhancement, as in malignant lymphoma (C). Ultrasound-guided biopsy was performed, and the diagnosis of Hodgkin lymphoma was confirmed
A 40-year-old female patient with B-symptoms and mediastinal tumor in the anterior mediastinum on computed tomography (A). Thoracic ultrasound indicated a complex hypoechoic tumor (B), which on contrast-enhanced ultrasound showed hyperenhancement, as in malignant lymphoma (C). Ultrasound-guided biopsy was performed, and the diagnosis of Hodgkin lymphoma was confirmed

Fig. 7.

A 68-year-old male patient with thoracic pressure sensation and tumor in the anterior mediastinum on computed tomography (A). Thoracic ultrasound indicated an inhomogeneous hypoechoic tumor (B), which showed hyperenhancement on contrast-enhanced ultrasound, as in malignant lymphoma (C). Ultrasound-guided biopsy was performed (D), and the diagnosis of diffuse large B-cell lymphoma was histologically confirmed
A 68-year-old male patient with thoracic pressure sensation and tumor in the anterior mediastinum on computed tomography (A). Thoracic ultrasound indicated an inhomogeneous hypoechoic tumor (B), which showed hyperenhancement on contrast-enhanced ultrasound, as in malignant lymphoma (C). Ultrasound-guided biopsy was performed (D), and the diagnosis of diffuse large B-cell lymphoma was histologically confirmed

Fig. 8.

A 47-year-old male patient with a smoking history and thoracic pressure sensation, increased thoracic cutaneous vessels (A) and mediastinal tumor on chest x-ray (B). Thoracic ultrasound revealed echogenic jugular veins with slow flow, as in superior vena cava syndrome (C), and mediastinal inhomogeneous echoic tumor (D), which showed inhomogeneous enhancement with necrosis (N) on contrast-enhanced ultrasound (E). A diagnosis of bronchial carcinoma was confirmed by ultrasound-guided biopsy
A 47-year-old male patient with a smoking history and thoracic pressure sensation, increased thoracic cutaneous vessels (A) and mediastinal tumor on chest x-ray (B). Thoracic ultrasound revealed echogenic jugular veins with slow flow, as in superior vena cava syndrome (C), and mediastinal inhomogeneous echoic tumor (D), which showed inhomogeneous enhancement with necrosis (N) on contrast-enhanced ultrasound (E). A diagnosis of bronchial carcinoma was confirmed by ultrasound-guided biopsy

Fig. 9.

A 46-year-old male patient with thoracic pressure and mediastinal tumor in the anterior mediastinum on computed tomography (A). Thoracic ultrasound indicated homogeneous low echo consolidation (B), which shows mixed central reduced enhancement on contrast-enhanced ultrasound. Here, the central tumor (TU) demarcates from the atelectasis (AT) (C). Transatelectatic ultrasound-guided biopsy was performed, and the diagnosis of bronchial carcinoma was confirmed histologically
A 46-year-old male patient with thoracic pressure and mediastinal tumor in the anterior mediastinum on computed tomography (A). Thoracic ultrasound indicated homogeneous low echo consolidation (B), which shows mixed central reduced enhancement on contrast-enhanced ultrasound. Here, the central tumor (TU) demarcates from the atelectasis (AT) (C). Transatelectatic ultrasound-guided biopsy was performed, and the diagnosis of bronchial carcinoma was confirmed histologically

Fig. 10.

A 71-year-old male patient with dyspnea and a mass in the anterior mediastinum on computed tomography (A). Thoracic ultrasound indicated a complex hypoechoic tumor (B), which on contrast-enhanced ultrasound showed large areas with lack of enhancement, as in necrosis (N), and only marginal vital tissue (C). Ultrasound-guided-biopsy from perfused tissue was performed, and the diagnosis of bronchial carcinoma was confirmed histologically
A 71-year-old male patient with dyspnea and a mass in the anterior mediastinum on computed tomography (A). Thoracic ultrasound indicated a complex hypoechoic tumor (B), which on contrast-enhanced ultrasound showed large areas with lack of enhancement, as in necrosis (N), and only marginal vital tissue (C). Ultrasound-guided-biopsy from perfused tissue was performed, and the diagnosis of bronchial carcinoma was confirmed histologically

Fig. 11.

A 48-year-old male patient with dyspnea and a mass in the anterior mediastinum on computed tomography (A). The patient had a history of a germ cell tumor. Thoracic ultrasound indicated a hypoechoic tumor (B), in which contrast-enhanced ultrasound showed large areas with absent enhancement, as in necrosis (N) (C). Ultrasound-guided biopsy from perfused tissue was performed, and the diagnosis of mediastinal malignant teratoma metastasis was histologically confirmed
A 48-year-old male patient with dyspnea and a mass in the anterior mediastinum on computed tomography (A). The patient had a history of a germ cell tumor. Thoracic ultrasound indicated a hypoechoic tumor (B), in which contrast-enhanced ultrasound showed large areas with absent enhancement, as in necrosis (N) (C). Ultrasound-guided biopsy from perfused tissue was performed, and the diagnosis of mediastinal malignant teratoma metastasis was histologically confirmed

Fig. 12.

A 52-year-old male patient with thoracic pressure sensation and mediastinal tumor in the anterior mediastinum on computed tomography (A). An osteosarcoma was known from the medical history. Thoracic ultrasound indicated an inhomogeneous hypoechoic tumor (B), which showed mixed central absent enhancement on contrast-enhanced ultrasound (C). Ultrasound-guided biopsy was performed, and the diagnosis of a mediastinal sarcoma metastasis was histologically confirmed (D)
A 52-year-old male patient with thoracic pressure sensation and mediastinal tumor in the anterior mediastinum on computed tomography (A). An osteosarcoma was known from the medical history. Thoracic ultrasound indicated an inhomogeneous hypoechoic tumor (B), which showed mixed central absent enhancement on contrast-enhanced ultrasound (C). Ultrasound-guided biopsy was performed, and the diagnosis of a mediastinal sarcoma metastasis was histologically confirmed (D)

Fig. 13.

A 58-year-old male patient with thoracic pressure sensation and a mediastinal tumor in the anterior mediastinum on computer tomography (A). A history of renal carcinoma was known. Thoracic ultrasound indicated a dumbbell-shaped, centrally hypoechoic and peripherally inhomogeneous echogenic tumor (B), which on contrast-enhanced ultrasound shows a marked enhancement centrally and peripherally, similar to that in peripheral atelectasis (AT) and central metastasis (M) (C). The diagnosis of a metastasis from renal cell carcinoma was histologically confirmed
A 58-year-old male patient with thoracic pressure sensation and a mediastinal tumor in the anterior mediastinum on computer tomography (A). A history of renal carcinoma was known. Thoracic ultrasound indicated a dumbbell-shaped, centrally hypoechoic and peripherally inhomogeneous echogenic tumor (B), which on contrast-enhanced ultrasound shows a marked enhancement centrally and peripherally, similar to that in peripheral atelectasis (AT) and central metastasis (M) (C). The diagnosis of a metastasis from renal cell carcinoma was histologically confirmed

Fig. 14.

A 79-year-old female patient with a mediastinal tumor in the anterior mediastinum on computed tomography as an incidental finding (A). Thoracic ultrasound indicated a hypoechoic tumor with localized multiple small star-like reflexogenic lesions (arrows) (AO = aorta) (B); the tumor showed marked enhancement on contrast-enhanced ultrasound (C). Ultrasound-guided biopsy was performed, and the diagnosis of B2 lymphoepithelial thymic carcinoma was histologically confirmed
A 79-year-old female patient with a mediastinal tumor in the anterior mediastinum on computed tomography as an incidental finding (A). Thoracic ultrasound indicated a hypoechoic tumor with localized multiple small star-like reflexogenic lesions (arrows) (AO = aorta) (B); the tumor showed marked enhancement on contrast-enhanced ultrasound (C). Ultrasound-guided biopsy was performed, and the diagnosis of B2 lymphoepithelial thymic carcinoma was histologically confirmed

Fig. 15.

A 71-year-old female patient with thoracic pressure sensation and a mediastinal tumor in the anterior mediastinum on computed tomography as well as an additional pleural lesion (A). Thoracic ultrasound indicated a hypoechoic lesion (B); the tumor showed marked homogeneous enhancement on contrast-enhanced ultrasound (C). Ultrasound-guided biopsy was performed, and the diagnosis of thymic carcinoma B1 was histologically confirmed
A 71-year-old female patient with thoracic pressure sensation and a mediastinal tumor in the anterior mediastinum on computed tomography as well as an additional pleural lesion (A). Thoracic ultrasound indicated a hypoechoic lesion (B); the tumor showed marked homogeneous enhancement on contrast-enhanced ultrasound (C). Ultrasound-guided biopsy was performed, and the diagnosis of thymic carcinoma B1 was histologically confirmed

Fig. 16.

A 27-year-old male patient with thoracic pressure sensation and a mediastinal tumor in the posterior mediastinum on chest x-ray (A). The tumor was visualized by MRI (T2 weighting) (B). Thoracic ultrasound indicated an inhomogeneous hypoechoic tumor, marginally solid with small reflexogenic lesions, centrally anechoic (C), which on contrast-enhanced ultrasound showed mixed centrally absent enhancement and peripheral hypoenhancement (D). Ultrasound-guided biopsy was performed, and the diagnosis of ganglioneuroma was histologically confirmed
A 27-year-old male patient with thoracic pressure sensation and a mediastinal tumor in the posterior mediastinum on chest x-ray (A). The tumor was visualized by MRI (T2 weighting) (B). Thoracic ultrasound indicated an inhomogeneous hypoechoic tumor, marginally solid with small reflexogenic lesions, centrally anechoic (C), which on contrast-enhanced ultrasound showed mixed centrally absent enhancement and peripheral hypoenhancement (D). Ultrasound-guided biopsy was performed, and the diagnosis of ganglioneuroma was histologically confirmed

Fig. 17.

A 34-year-old male patient with thoracic pressure sensation and a mediastinal tumor in the posterior mediastinum on computed tomography (A). The tumor was visualized by MRI (T2 weighting) (B). Thoracic ultrasound indicated an echogenic tumor with small anechoic lesions (C), which showed inhomogeneous marked enhancement on contrast-enhanced ultrasound (D). Ultrasound-guided biopsy was performed (E), and the diagnosis of schwannoma was histologically confirmed
A 34-year-old male patient with thoracic pressure sensation and a mediastinal tumor in the posterior mediastinum on computed tomography (A). The tumor was visualized by MRI (T2 weighting) (B). Thoracic ultrasound indicated an echogenic tumor with small anechoic lesions (C), which showed inhomogeneous marked enhancement on contrast-enhanced ultrasound (D). Ultrasound-guided biopsy was performed (E), and the diagnosis of schwannoma was histologically confirmed

Fig. 18.

An 18-year-old male patient with thoracic pressure sensation and a mediastinal tumor in the posterior mediastinum on computed tomography (A). The tumor was visualized by MRI (T2 weighting) (B). Thoracic ultrasound indicated a complex tumor with anechoic areas (C), which on contrast-enhanced ultrasound showed inhomogeneous focal enhancement with areas lacking enhancement (D). Ultrasound-guided biopsy was performed, and the diagnosis of giant cell tumor was histologically confirmed
An 18-year-old male patient with thoracic pressure sensation and a mediastinal tumor in the posterior mediastinum on computed tomography (A). The tumor was visualized by MRI (T2 weighting) (B). Thoracic ultrasound indicated a complex tumor with anechoic areas (C), which on contrast-enhanced ultrasound showed inhomogeneous focal enhancement with areas lacking enhancement (D). Ultrasound-guided biopsy was performed, and the diagnosis of giant cell tumor was histologically confirmed

Fig. 19.

A 55-year-old female patient with thoracic pressure sensation and a mediastinal tumor in the posterior mediastinum, with an additional ventral pleural lesion on computed tomography (A). A history of malignant phyllodes tumors of the breast was known. Thoracic ultrasound indicated an inhomogeneous hypoechoic tumor (B), which on contrast-enhanced ultrasound showed a mixed central absent enhancement and marginal marked enhancement (C). Ultrasound-guided biopsy was performed, and the diagnosis of a metastasis from a malignant phyloid tumor of the breast was histologically confirmed
A 55-year-old female patient with thoracic pressure sensation and a mediastinal tumor in the posterior mediastinum, with an additional ventral pleural lesion on computed tomography (A). A history of malignant phyllodes tumors of the breast was known. Thoracic ultrasound indicated an inhomogeneous hypoechoic tumor (B), which on contrast-enhanced ultrasound showed a mixed central absent enhancement and marginal marked enhancement (C). Ultrasound-guided biopsy was performed, and the diagnosis of a metastasis from a malignant phyloid tumor of the breast was histologically confirmed
eISSN:
2451-070X
Sprache:
Englisch
Zeitrahmen der Veröffentlichung:
4 Hefte pro Jahr
Fachgebiete der Zeitschrift:
Medizin, Vorklinische Medizin, Grundlagenmedizin, andere
Zeitschrift RSS Feed