Education  |   March 2018
A Large Anterior Mediastinal Mass
Author Notes
  • From the Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.
  • Charles D. Collard, M.D., served as Handling Editor for this article.
    Charles D. Collard, M.D., served as Handling Editor for this article.×
  • Address correspondence to Dr. Stubblefield: jonathan.stubblefield@phhs.org
Article Information
Education / Images in Anesthesiology / Respiratory System / Thoracic Anesthesia
Education   |   March 2018
A Large Anterior Mediastinal Mass
Anesthesiology 3 2018, Vol.128, 637. doi:10.1097/ALN.0000000000001931
Anesthesiology 3 2018, Vol.128, 637. doi:10.1097/ALN.0000000000001931
A LARGE anterior mediastinal mass (AMM) poses significant challenges for hemodynamic and airway management. This image demonstrates a 19 x 11 x 10 cm B-cell lymphoma compressing the tracheobronchial tree and pulmonary arterial vasculature. AMMs are predominantly malignancies such as lymphomas or thymomas.
Signs or symptoms of mediastinal compression such as orthopnea or upper body edema are strong predictors of perioperative complications.1  Prognostic computed tomography findings include a tracheal cross-sectional area less than 50% or mainstem bronchus compression, as demonstrated in this image.2  Evidence of a pericardial effusion is also strongly predictive of hemodynamic complications intraoperatively.1,3 
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