TITLE:
Mediastinoscopy in Assessing Mediastinal Lymphadenopathy and Lung Disease
AUTHORS:
Iskander Al-Githmi
KEYWORDS:
Mediastinoscopy, Mediastinum, Lymphadenopathy, Lung, Cancer
JOURNAL NAME:
Open Journal of Thoracic Surgery,
Vol.7 No.4,
December
5,
2017
ABSTRACT: Background: Mediastinoscopy is the gold standard procedure for the pathological
staging and diagnosis of mediastinal diseases. The aim of the study is to
describe the significance of anterior cervical Mediastinoscopy in evaluating
patients with mediastinal lymphadenopathy and lung parenchymal disease. Material
and Methods: From January 2014 until June 2017 we conducted a retrospective
study of 52 consecutive patients with mediastinal lymphadenopathy and lung
parenchymal disease who underwent anterior cervical Mediastinoscopy. The main
indications for cervical Mediastinoscopy were isolated mediastinal
lymphadenopathy, undetermined lung mass with mediastinal lymphadenopathy, and
the clinical staging of patients with lung cancer. Results: The study
subjects consisted of 37 men and 15 women, aged 13 to 87 (mean age 50.8). Eight
patients had mediastinoscopy for staging lung cancer, 27 patients had
mediastinoscopy to diagnose isolated mediastinal lymphadenopathy, and 17
patients had mediastinoscopy for an undetermined lung parenchymal mass. Among
the patients with isolated mediastinal lymphadenopathy, sarcoidosis was
diagnosed in 6, tuberculosis in 9, reactive lymph nodes in 4, metastasis in 5
and lymphoma in 3. Lymph node metastasis (N2, N3) was found in 5 patients with
lung cancer. There was no surgical-related mortality or morbidity. Conclusions: Mediastinoscopy is a safe and reliable procedure in diagnosing mediastinal
diseases and is still the first choice among the investigative modalities in
the clinical staging of bronchogenic carcinoma.