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The diagnosis of a mediastinal germ cell tumor should be considered in all young males with a mediastinal mass. In addition to physical examination and routine laboratory studies, initial evaluation should include CT of the chest and abdomen, and determination of serum levels of HCG and alpha-fetoprotein.
The mediastinum has three main parts: the anterior mediastinum (front), the middle mediastinum, and the posterior mediastinum (back). Masses in the anterior portion of the mediastinum can include thymoma, lymphoma , pheochromocytoma , germ cell tumors including teratoma , thyroid tissue, and parathyroid lesions.
Primary mediastinal B-cell lymphoma, abbreviated PMBL or PMBCL, is a rare type of lymphoma that forms in the mediastinum (the space in between the lungs) and predominantly affects young adults. [ 1 ] [ 2 ] [ 3 ]
Chronic sclerosing (or fibrosing) mediastinitis, while potentially serious, is caused by a long-standing inflammation of the mediastinum, leading to growth of acellular collagen and fibrous tissue within the chest and around the central vessels and airways. It has a different cause, treatment, and prognosis than acute infectious mediastinitis.
The average age of diagnosis is between 35 and 50 years. This is about 5 to 10 years older than men with other germ cell tumors of the testes. In most cases, they produce masses that are readily felt on testicular self-examination; however, in up to 11 percent of cases, there may be no mass able to be felt, or there may be testicular atrophy ...
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Micrograph of a primary mediastinal large B-cell lymphoma, a cause of mediastinal lymphadenopathy. H&E stain. Mediastinal lymphadenopathy or mediastinal adenopathy is an enlargement of the mediastinal lymph nodes.