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      종격동 기형종: 임상 화보 Translated title: Mediastinal Teratoma: A Pictorial Essay

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          Abstract

          종격동은 생식선 이외에서 발생하는 기형종의 가장 호발하는 부위로 알려져 있다. 종격동 성숙 기형종은 주로 젊은 성인에서 나타나고 남녀 간 발생 빈도의 큰 차이 없이 나타난다. 종격동 기형종은 대부분 전종격동에서 관찰되고, 일반적으로 증상을 보이지 않지만 종괴의 크기가 크거나 파열이 발생할 경우 여러 합병증이 나타날 수 있다. 종격동 기형종은 대부분 조직 검사 없이 전산화단층촬영(CT)만으로 진단될 수 있다. 하지만 파열된 기형종 혹은 악성 기형종의 경우 임상적 그리고 영상의학적으로 비전형적인 양상을 보여 진단이 어려울 수 있다. 본 종설에서는 종격동 기형종의 다양한 발현 양상을 영상 검사 소견을 중심으로 살펴보고자 한다.

          Translated abstract

          The mediastinum is the most prevalent site of extragonadal teratomas. Patients with mediastinal mature teratomas are usually young adults, and the condition does not show significant sexual differences. Mediastinal teratomas are mostly located in the anterior mediastinum. Patients are usually asymptomatic, although they can have several complications when the teratomas become large or rupture. Most mediastinal teratomas can be diagnosed using CT. Diagnosing ruptured or malignant teratomas is challenging because of their atypical clinical and radiological presentations. In this article, we describe various manifestations of mediastinal teratomas, with an emphasis on radiologic features.

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          Most cited references27

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          Ovarian teratomas: tumor types and imaging characteristics.

          Ovarian teratomas include mature cystic teratomas (dermoid cysts), immature teratomas, and monodermal teratomas (eg, struma ovarii, carcinoid tumors, neural tumors). Most mature cystic teratomas can be diagnosed at ultrasonography (US) but may have a variety of appearances, characterized by echogenic sebaceous material and calcification. At computed tomography (CT), fat attenuation within a cyst is diagnostic. At magnetic resonance (MR) imaging, the sebaceous component is specifically identified with fat-saturation techniques. The US appearances of immature teratoma are nonspecific, although the tumors are typically heterogeneous, partially solid lesions, usually with scattered calcifications. At CT and MR imaging, immature teratomas characteristically have a large, irregular solid component containing coarse calcifications. Small foci of fat help identify these tumors. The US features of struma ovarii are also nonspecific, but a heterogeneous, predominantly solid mass may be seen. On T1- and T2-weighted images, the cystic spaces demonstrate both high and low signal intensity. Familiarity with the US, CT, and MR imaging features of ovarian teratomas can aid in differentiation and diagnosis.
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            Imaging of cystic masses of the mediastinum.

            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. Copyright RSNA, 2002
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              Anterior mediastinal tumors: diagnostic accuracy of CT and MRI.

              To compare the diagnostic accuracy for anterior mediastinal tumors among CT, MRI, and both CT and MRI, and to determine the optimal CT and MRI procedures for the diagnosis of anterior mediastinal tumors.
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                Author and article information

                Journal
                Taehan Yongsang Uihakhoe Chi
                Taehan Yongsang Uihakhoe Chi
                JKSR
                Journal of the Korean Society of Radiology (Taehan Yŏngsang Ŭihakhoe chi)
                The Korean Society of Radiology
                1738-2637
                2288-2928
                May 2022
                25 May 2022
                : 83
                : 3
                : 597-607
                Affiliations
                [1 ]전남대학교 의과대학 영상의학교실 [1 ]Department of Radiology, Chonnam National University Medical School, Gwangju, Korea.
                [2 ]전남대학교 의과대학 화순전남대학교병원 폐식도 클리닉 [2 ]Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Korea.
                [3 ]전남대학교 의과대학 흉부심장혈관외과학교실 [3 ]Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School, Gwangju, Korea.
                [4 ]전남대학교 의과대학 병리학교실 [4 ]Department of Pathology, Chonnam National University Medical School, Gwangju, Korea.
                Author notes
                Corresponding author: Won Gi Jeong, MD. Department of Radiology, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea. Tel 82-62-220-5746, Fax 82-62-220-4380, wgjung86@ 123456naver.com
                Article
                10.3348/jksr.2021.0186
                9514525
                36238516
                425e1be0-fca6-4fee-90bf-f1d47d7ad19a
                Copyrights © 2022 The Korean Society of Radiology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 03 December 2021
                : 29 December 2021
                : 07 January 2022
                Categories
                Thoracic Imaging
                Pictorial Essay

                mediastinum,teratoma,malignant teratoma
                mediastinum, teratoma, malignant teratoma

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