Mediastinum

C38.1-C38.3WHO Vol. 5

Thorax (Respiratory & Mediastinum)

Prognosis

This section is being prepared by our editorial process.

🔬 Histological Types

📚 Latest Research

2026-09-10

Cytokine concentrations in pediatric primary mediastinal large B cell lymphoma correlate with disease extent and outcome.

Nipper M, et al

A population-based study of 62 pediatric patients with primary mediastinal large B-cell lymphoma (PMBCL) identified pretreatment plasma cytokine profiles that distinguish tumor burden from prognosis, with IL-6 showing the strongest link to outcome — a hazard ratio of 6.8 (95% CI, 1.5–30.9) for inferior event-free survival. CCL17 levels were dramatically elevated in PMBCL patients compared to 26 age-matched controls (median 1695 pg/ml vs. 81 pg/ml; p<0.0001), and CCL17, CXCL9, and CXCL10 correlated significantly with mediastinal tumor volume and lactate dehydrogenase activity, though not with survival. In a uniformly treated subgroup of 50 patients receiving dose-adjusted EPOCH with rituximab, elevated IL-6, IL-10, IL-17A, and IL-22 each predicted inferior event-free survival, establishing a panel of novel biomarkers that may guide risk stratification in this lymphoma subtype currently lacking established prognostic markers.

Blood advances

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2026-09-09

Neurofibromatosis Type 1 Tumor Involving the Anterosuperior Mediastinum With a Rare c.147C>G Germline Mutation: A Case Report.

Qi Y, et al

A 41-year-old male with Neurofibromatosis Type 1 (NF1) was found to have a solitary neurofibroma in the anterosuperior mediastinum, which was completely resected via uniportal video-assisted thoracoscopic surgery (VATS) with no evidence of recurrence at 1-year postoperative follow-up. Genetic analysis of the tumor tissue identified two heterozygous nonsense variants in the NF1 gene — the rare pathogenic variant c.147C>G (p.Tyr49Ter) and the common pathogenic variant c.1318C>T (p.Arg440Ter) — while next-generation sequencing of the patient's son's blood revealed only the rare c.147C>G variant, underscoring the hereditary dimension of this case. Because NF1 patients face a markedly increased risk of developing malignant peripheral nerve sheath tumors (MPNSTs), which carry poor 5-year survival outcomes, the authors emphasize that comprehensive genetic testing and a multidisciplinary evaluation of mediastinal masses are essential for accurate diagnosis, risk stratification, and preventive strategies.

Clinical case reports

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2026-09-09

Tumor-to-thoracic height and width ratios as adjunct imaging markers for preoperative risk stratification in minimally invasive surgery for pediatric mediastinal masses.

Makita S, et al

A retrospective study of 65 children with mediastinal masses demonstrated that two simple preoperative imaging ratios — the tumor-to-thoracic height ratio (TTH) and tumor-to-thoracic width ratio (TTW) — are strongly associated with intraoperative complications during minimally invasive surgery (MIS), with complication patients showing significantly higher values (TTH: 0.51 vs. 0.26, p=0.004; TTW: 0.67 vs. 0.37, p=0.005). Of the 56 children who underwent MIS, complications occurred in 5, and receiver operating characteristic analysis revealed excellent discriminatory performance, with area under the curve values of 0.894 for TTH and 0.882 for TTW. Both ratios are derived from routine preoperative chest radiography combined with CT or MRI, making them practical adjunct tools that may help surgeons identify high-risk pediatric patients and optimize surgical planning — including potential conversion to open thoracotomy — before operating on mediastinal tumors.

Pediatric surgery international

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