Mediastinal lesions across the age spectrum: a clinicopathological comparison between pediatric and adult patients

// Tingting Liu 1 , Lika’a Fasih Y. Al-Kzayer 2 , Xiao Xie 3 , Hua Fan 4 , Shamil Naji Sarsam 5 , Yozo Nakazawa 2 and Lei Chen 6 1 Department of Pediatric Hematology/Oncology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China 2 Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan 3 Department of Thoracic Cardiovascular Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China 4 Department of Radiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China 5 Department of Radiology, Ibn Al-Nafees Hospital, Manama, Kingdom of Bahrain 6 Department of Pathology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China Correspondence to: Lei Chen, email: chenlei021@sina.com Keywords: mediastinal lesions, age distribution, histopathological distribution, the mediastinum Received: January 30, 2017 Accepted: April 06, 2017 Published: April 18, 2017 ABSTRACT The objective of this study was to identify the differences in histopathological distribution and clinical features of mediastinal lesions (MLs) across the age spectrum in Chinese series of patients and to compare with the available literature. A total of 409 cases of MLs, including 137 pediatric and 272 adult patients from a single institution, was reviewed and categorized into groups according to age. Among the 409 cases, the age showed a bimodal distribution with an increased incidence of MLs among (< 10 year) and (60–< 70 year) age groups. Thymic lesions, neurogenic tumors, and cysts made up 57% of MLs among the 409 cases. A significantly higher frequency was found for neurogenic tumors, germ cell tumors, mesenchymal tumors, and lymphatic lesions, ( p < 0.01) for all, in pediatric population compared to adults. On the contrary, frequencies of thymic lesions and metastatic carcinomas were significantly higher in adults compared to pediatric category, ( p < 0.01) for both. Overall, 41.6% were asymptomatic, however, pediatric patients showed a significantly higher incidence of cough and fever, ( p < 0.01) for both, and dyspnea ( p = 0.02), than adults. Whereas adult subset showed a significantly higher incidence of chest pain ( p = 0.02), or oppression ( p < 0.01), than pediatric counterpart. In conclusion, the age spectrum was the factor that influenced the histopathological distribution and the clinical presentation of MLs in Chinese series of patients. Such differences might be considered in the differential diagnosis and therapeutic approach for adult as well as pediatric patients with MLs. Furthermore, our study was comparable to the literature in terms of MLs frequencies.