Improving diagnosis of chest tumors

Is it cancer or a fungal infection? For children with a mass or lump in their chest cavity, the answer is not always immediately clear.

No single sign or test can reveal which masses are cancerous and which are benign tumors caused by the fungal infection histoplasmosis. For many patients, a diagnosis requires biopsy surgery.

Research led by St. Jude investigators could lead to a faster and simpler approach.

Scientists found two previously overlooked clues in the health records of 131 children and teens with chest masses. Patients with enlarged lymph nodes in the neck and low levels of certain white blood cells were more likely to have cancer. Masses located in front of the heart were also more likely to be malignant. The results were published in the Journal of Pediatrics.

Researchers now plan to track whether factors discovered in this study will allow faster and more accurate diagnoses without surgery.

“The problem has been that there are both benign and malignant causes of these masses,” said Elisabeth Adderson, MD, of St. Jude Infectious Diseases. “In some parts of the country, particularly in the Ohio and Mississippi River valleys, the masses are more likely to be caused by infection than cancer.”

July 22, 2015

Read the news release

Full citation
Naeem F, Metzger ML, Arnold SR, Adderson EE. Distinguishing Benign Mediastinal Masses from Malignancy in a Histoplasmosis-Endemic Region. J Pediatr 167(2):409-15, 2015. doi: 10.1016/j.jpeds.2015.04.066