Abstract

Background: Mediastinal tumors (MT) are a group of diseases with diverse histopathological characteristics and non-specific clinical symptoms. They are often discovered incidentally through imaging modalities such as computed tomography (CT). Objective: to investigate the correlation between CT features and histopathological characteristics in patients with mediastinal tumors at Pham Ngoc Thach Hospital. Materials and Methods: A descriptive cross-sectional retrospective study was performed on 393 patients who had CT scans showing mediastinal tumors and had biopsy or surgical specimens available at Pham Ngoc Thach Hospital from January 2016 to June 2022. Imaging features were compared with histopathological results using univariate regression analysis. Results: The mean tumor size was 6.68 ± 2.26 cm. Tumor location was strongly associated with histological subgroups: the anterior mediastinum was predominantly thymic epithelial tumors (67.8%), the posterior mediastinum consisted of 97.1% soft tissue tumors, and the middle mediastinum was most commonly associated with metastatic tumors (100% of cases were mediastinal lymph node metastases). The study identified several CT signs that were significantly associated with malignancy (p < 0.01), including: irregular lesion margins (OR 7.23 [3.93 - 13.29]), invasion of surrounding organs (OR 18.83 [6.71 - 52.82]), heterogeneous tumor density (OR 9.86 [6.19 - 15.72]), and heterogeneous contrast enhancement (OR 14.59 [8.88 - 23.96]). Conclusion: CT imaging plays an important role in localizing mediastinal tumors, suggesting histological subgroups, and assessing the likelihood of malignancy.