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 in the neck. 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 is usually taken at the end of the procedure.
The procedure usually takes 60 - 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 after the procedure.
Most patients are released from the hospital the next morning.
The results of the biopsy are usually ready in 5 - 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 Values: Biopsies of lymph node tissues are normal and do not show signs of cancer or infection.
What abnormal results mean: Abnormal findings may indicate:
What the risks are: There is a risk of puncturing the esophagus, trachea, or blood vessels. In some circumstances, this can lead to potentially fatal bleeding.
References:
Park DR, Valliares E. Tumors and cysts of the mediastinum. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 76.
Putnam JB Jr. Lung, chest wall, pleura, and mediastinum. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 58.
Gamliel Z. Surgical staging for non-small cell lung cancer. Surg Oncol Clin N Am. 2011;20(4):691-700.
Lerut T, De Leyn P, Coosemans W, Decaluwe H, Decker G, Nafteux P, et al. Cervical videomediastinoscopy. Thorac Surg Clin. 2010;20(2):195-206.
