[Mediastinum-new compartment classification]

Mediastinal masses are common and comprise a heterogeneous spectrum of disorders. Correct diagnosis has prognostic and therapeutic consequences, which is why precise localization of lesions and interdisciplinary management are essential in clinical practice. This article describes traditional divisions of mediastinum lesions and presents the new classification based on cross-sectional imaging, which was developed by the International Thymic Malignancy Interest Group (ITMIG).

Which divisions of the mediastinum have been used so far and how does the division developed by the ITMIG differ? What are the advantages of the new mediastinal classification?

Comparison of the previously used mediastinal classification with the new mediastinal classification developed by ITMIG and visualization of the respective methods. In addition, pathologies typical for the respective compartments are explained.

The traditional compartmentalization of the mediastinum into an anterior, middle, and posterior mediastinum is not clearly defined and may lead to confusing interdisciplinary communication. Since these classifications are mostly based on projection radiographs, the proposed three-dimensional classification of the ITMIG is a development that suits the modern clinical workflow and promotes standardization. The three mediastinal compartments should thus be termed prevascular, visceral, and paravertebral.