title: Mature mediastinal teratoma: sonographic imaging patterns and pathologic correlation.
abstract: OBJECTIVE
  To characterize the sonographic patterns of teratomas located within the mediastinum and to correlate them with pathologic findings, because there have been few reports concerning the application of sonography in the diagnosis of mediastinal teratoma.
  
  
  METHODS
  Over a 9-year period, we carried out an image analysis of the sonographic findings of 28 mediastinal teratomas whose diagnoses were proved surgically.
  
  
  RESULTS
  Sonography showed that 18 patients had a complex mass of heterogeneous echogenicity, including regional bright echoes (n = 12), acoustic shadows (n = 8), hyperechoic lines and dots (n = 7), soft tissue septa (n = 9), dermoid plugs (n = 6), and hypoechoic areas (n = 11). This type of mediastinal teratoma revealed, in pathologic findings, varying combinations of fat, sebaceous and mucinous materials, hair, mineralized elements, and multiple compartments. Eight patients had a homogeneous hyperechoic mass, and the 2 remaining patients had floating spherules within a cystic mass. Pathologically, the homogeneous mass mainly contained hair and sebaceous material. The floating spherules were also composed of sebaceous tissue and were above the fluid of the cyst.
  
  
  CONCLUSIONS
  On the basis of the evaluation of the sonographic and pathologic findings, we described 3 major patterns of mediastinal teratoma: a complex mass of heterogeneous echogenicity, homogeneous high echogenicity within a solid mass, and floating spherules within a cystic mass. Thus, sonography can improve the diagnosis of mediastinal teratoma. However, additional prospective studies are needed to test the sensitivity and specificity of these sonographic patterns in the diagnosis of mediastinal teratoma.
authors.affiliation: Department of Internal Medicine, Taipei County San-Chung Hospital, Taiwan, Republic of China.
authors.forename: Tsu-Tuan
authors.initials: TT
authors.lastname: Wu
authors.forename: Hao-Chien
authors.initials: HC
authors.lastname: Wang
authors.forename: Yeun-Chung
authors.initials: YC
authors.lastname: Chang
authors.forename: Yung-Chie
authors.initials: YC
authors.lastname: Lee
authors.forename: Yih-Leong
authors.initials: YL
authors.lastname: Chang
authors.forename: Pan-Chyr
authors.initials: PC
authors.lastname: Yang
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008482:Mediastinum / Q000473:pathology; D012189:Retrospective Studies; D013724:Teratoma / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography