Cervicothoracic lesions in infants and children

Cervicothoracic lesions are not uncommon in children. AU cervicothoracic le sions except superficial lesions extend from the neck to the thorax through the thoracic inlet. Evaluation of this area involves multiple imaging moda lities: plain radiography, ultrasonography, nuclear medicine, computed tomo graphy, and magnetic resonance (MR) imaging. However, MR imaging is the met hod of choice for assessing the full extents of cervicothoracic lesions and their relationships to neurovascular structures. Cervicothoracic lesions c an be classified as congenital lesions, inflammatory lesions, benign tumors , malignant tumors, and traumatic lesions. Lymphangioma is the most common cervicothoracic mass in children; other congenital lesions include hemangio ma, thymic cyst, and vascular anomalies. Inflammatory adenopathy reactive t o tuberculosis, mononucleosis, tularemia, cat-scratch fever, infection with human immunodeficiency virus, or other upper respiratory tract infections can manifest as cervicothoracic lesions; tuberculous abscesses and abscesse s of other origins can also be seen. Lipoma, Lipoblastoma, aggressive fibro matosis, and nerve sheath tumors (either isolated lesions or those associat ed with neurofibromatosis) can also occur as cervicothoracic masses. Malign ant cervicothoracic tumors include lymphoma, thyroid carcinoma, neuroblasto ma, and chest wall tumors (rhabdomyosarcoma, Ewing sarcoma, and neuroectode rmal tumor). Traumatic cervicothoracic lesions include pneumomediastinum of traumatic origin, traumatic pharyngeal pseudodiverticulum, esophageal fore ign-body granuloma, and cervicothoracic hematoma.