BMJ 2001;322:302 ( 3 February )

Letters

Differential diagnoses for asthma should include mediastinal masses

The first 150 words of the full text of this article appear below.

EDITOR---The article by Payne et al emphasised the need to challenge the diagnosis of asthma in children whose symptoms of airways obstruction persist on treatment.1 The authors presented a table entitled "Diagnoses that may mimic or coexist with asthma." We have had many experiences of children with mediastinal masses who were initially diagnosed as having asthma, and we feel that airways obstruction due to malignancy should also be included in the differential diagnosis. The inclusion of mediastinal masses is important, although they are uncommon, since airways obstruction due to malignancy is not a stable condition and if unrecognised will go on to cause critical airways compression and respiratory arrest.

The crucial clinical sign in patients with airways obstruction due to malignancy is stridor rather than wheeze, and it is the difficulty in distinguishing between these that usually leads to delays in diagnosis. Other signs associated with mediastinal masses, . . . [Full text of this article]
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This article has been cited by other articles:

  • Murray, M. J, Nicholson, J. C, McShane, D. (2008). Don't forget mediastinal masses. BMJ 336: 521-522 [Full text]  
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