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Mediastinoscopy with biopsy

 

Mediastinoscopy with biopsy is a procedure in which a lighted instrument (mediastinoscope) is inserted in the space in the chest between the lungs (mediastinum). Tissue is taken (biopsy) from any unusual growth or lymph nodes.

How the Test is Performed

This procedure is done in the hospital. You will be given general anesthesia so that you are asleep and do not feel any pain. A tube (endotracheal tube) is placed in your nose or mouth to help you breathe.

A small surgical cut is made just above the breastbone. A device called a mediastinoscope is inserted through this cut and gently passed into the mid-part of the chest.

Tissue samples are taken of the lymph nodes around the airways. The scope is then removed and the surgical cut is closed with stitches.

A chest x-ray will often be taken at the end of the procedure.

The procedure takes about 60 to 90 minutes.

How to Prepare for the Test

 

You must sign an informed consent form. You will not be able to have food or fluid for 8 hours before the test.

 

How the Test will Feel

 

You will be asleep during the procedure. There will be some tenderness at the site of the procedure afterward. You may have a sore throat.

Most people can leave the hospital the next morning.

In most cases, the result of the biopsy is ready in 5 to 7 days.

 

Why the Test is Performed

 

This procedure is done to look at and then biopsy lymph nodes or any other abnormal growths in the front part of the mediastinum, near your chest wall.

  • The most common reason is to see if lung cancer (or another cancer) has spread to these lymph nodes. This is called staging.
  • This procedure is also done for certain infections (tuberculosis, sarcoidosis) and autoimmune disorders.

 

Normal Results

 

Biopsies of lymph node tissues are normal and do not show signs of cancer or infection.

 

What Abnormal Results Mean

 

Abnormal findings may indicate:

  • Hodgkin disease
  • Lung cancer
  • Lymphoma or other tumors
  • Sarcoidosis
  • The spread of disease from one body part to another
  • Tuberculosis

 

Risks

 

There is a risk of puncturing the esophagus, trachea, or blood vessels. In some cases, this can lead to bleeding that can be life threatening. To fix the injury, the breastbone would need to be split and the chest opened.

 

 

References

Cheng G-S, Varghese TK. Mediastinal tumors and cysts. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray & Nadel's Textbook of Respiratory Medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 83.

Putnam JB Jr. Lung, chest wall, pleura, and mediastinum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 57.

 
  • Mediastinum

    Mediastinum - illustration

    Mediastinoscopy is a procedure in which a lighted instrument (mediastinoscope) is inserted through a neck incision to visually examine the structures in the top of the chest cavity and take tissue samples. This procedure can be used to biopsy lymph nodes surrounding the airway to help diagnose or see how far a particular disease has spread.

    Mediastinum

    illustration

    • Mediastinum

      Mediastinum - illustration

      Mediastinoscopy is a procedure in which a lighted instrument (mediastinoscope) is inserted through a neck incision to visually examine the structures in the top of the chest cavity and take tissue samples. This procedure can be used to biopsy lymph nodes surrounding the airway to help diagnose or see how far a particular disease has spread.

      Mediastinum

      illustration

    A Closer Look

     

      Tests for Mediastinoscopy with biopsy

       

       

      Review Date: 5/24/2016

      Reviewed By: Mary C. Mancini, MD, PhD, Department of Surgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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