"Straddling across boundaries"-thoracoabdominal lesions: spectrum and pattern approach.

Area of Science:

• Radiology
• Anatomy
• Pathology

Background:

• The thoracoabdominal region comprises the lower thorax and upper abdomen, separated by the diaphragm.
• The diaphragm, while a barrier, can be traversed by lesions extending between the thorax and abdomen.
• Lesions can cross the diaphragm via natural openings (e.g., esophageal hiatus) or abnormal defects.

Purpose of the Study:

• To classify and describe the imaging appearance of thoracoabdominal lesions straddling the diaphragm.
• To elucidate the routes of transdiaphragmatic extension for various pathologies.
• To enhance understanding of the thoracoabdominal continuum and lesion pathways.

Main Methods:

• Pattern-based classification of lesions by location and extension route (central vs. lateral).
• Categorization of central lesions by specific anatomical locations (e.g., esophageal, retrocrural).
• Depiction of imaging findings for a wide spectrum of thoracoabdominal lesions.

Main Results:

• Thoracoabdominal lesions can extend through natural openings (vena caval, esophageal, retrocrural hiatuses) or abnormal defects (congenital or acquired).
• Lesions are classified as central (anterior, tendon, vena caval, esophageal, retrocrural) or lateral.
• Etiologies are diverse, including congenital, neoplastic, inflammatory, iatrogenic, and traumatic causes, presenting as solid masses, cysts, or collections.

Conclusions:

• A pattern approach aids in classifying thoracoabdominal lesions based on their extension routes across the diaphragm.
• Recognizing these diverse pathologies and their imaging characteristics is crucial for accurate diagnosis.
• Familiarity with transdiaphragmatic extension pathways improves understanding of thoracoabdominal disease.