. Roentgen interpretation; a manual for students and practitioners . medias-tinal tumors by the fact that it moves with deglutition. Mediastinal masses may be due to enlargements of the medias-tinal glands, growths, aneurysms, vertebral abscesses and dilatationsof the esophagus. Enlargement of the glands is usually due to tuberculosis,Hodgkins disease or malignancy. Their outline is sharp and irregu-lar or lobulated and the process is usually bilateral. They seldomshow pulsation although large masses may transmit the impulse 112 THE CHEST of heart or aorta. By careful fluoroscopic examination
. Roentgen interpretation; a manual for students and practitioners . medias-tinal tumors by the fact that it moves with deglutition. Mediastinal masses may be due to enlargements of the medias-tinal glands, growths, aneurysms, vertebral abscesses and dilatationsof the esophagus. Enlargement of the glands is usually due to tuberculosis,Hodgkins disease or malignancy. Their outline is sharp and irregu-lar or lobulated and the process is usually bilateral. They seldomshow pulsation although large masses may transmit the impulse 112 THE CHEST of heart or aorta. By careful fluoroscopic examination it is some-times possible to separate their shadow from that of the aorta orto demonstrate a normal aorta. The most common tumors are lymphosarcoma, Hodgkins disease,and carcinoma, primary or metastatic. They produce denseshadows with sharply defined borders and may displace or com-press the surrounding organs, often showing transmitted pul-sation. They may-be mistaken for aneurysm, but careful studywith the fluoroscope and plates at difl:erent angles will usually. Fig. 88.—Malignant tumor of the mediastinum, resembling aneurysm. difterentiate them. In lymphosarcoma and Hodgkins disease, glandselsewhere in the bod} are usually involved and the masses tempo-rarily disappear with great rapidity under roentgen radniatio.^Primary malignancy is rare. It usually occurs as a unilateral,irregular enlargement of the hilus shadow which shows a tendencyto grow in the direction of the affected bronchi. Metastatic malig-nancy, in addition to the enlargement of the hilus shadows, mayshow the characteristic, annular, sharply defined patches through thelung fields. Teratomata may invade the mediastinum in rare cases, THYROID 113
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