Subtle Radiographic Findings in Mediastinal and Paramediastinal Lesions: A Radiologist’s Perspective
Irrespective of recent developments in thoracic imaging, conventional chest radiography remains as the most common tool for initial assessment of the chest. However, mediastinal and paramediastinal lesions are easily ignored on chest radiographs. In clinical practice, mediastinal widening is frequently described for suspected mediastinal lesions. Yet there is no objective assessment for definitive determination of how wide is really wide or the anatomic location of the lesion. Anatomically, mediastinal reflections represent points of contact between the mediastinum and adjacent lung giving rise to many “lines and stripes” on chest radiographs. Despite seemingly old-fashioned, these lines and stripes are fundamental and essential for identification of subtle mediastinal or paramediastinal lesions. In this presentation, I will review and illustrate subtle but crucial radiographic findings of various mediastinal and paramediastinal diseases and discuss how to avoid overlooking such minute features that may reflect important underlying diseases from a radiologist’s perspective. Finally, I will share some of my experiences in clinical researches through the story of a vein in the mediastinum.
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