Anterior mediastinal masses

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-If the patient does not have history of lymphoma, we report that the mass seen in the anterior mediastinum is thymoma after exclusion of the retrosternal goiter.

But if the patient has a history of lymphoma, we report this mass as thymic lymphoma.

So if we have an anterior mediastinal mass, look first if it is connected to the neck by a thyroid goiter or not, If it is connected, diagnose it as retrosternal goiter. 

If it is not connected, ask about lymphoma history or presence of other lesions in the spleen or lymph nodes, if present, diagnose thymic lymphoma, if not present diagnose thymoma.

-How to differentiate between thymic lymphoma and thymoma in adults or children:

By floating vessels sign, in which in case of thymoma, the vessels will be displaced posteriorly, while in case of lymphoma, the vessels will be seen floating inside the mass.

-Invasive thymoma causes encasement of the vessels or airways such as SVC.

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