Mediastinoscopy for diagnosis of disease characteristic with mediastinal mass only / 中华胸心血管外科杂志

ABSTRACT

Objective To assess the usefulness video-assisted mediastinoscopy (VM) for diagnosis of disease characteristic with mediastinal mass. Analyze the correlations of clinical features of the disease with the pathologic diagnosis. Methods Between July 2000 and March 2006, 97 undiagnosed patients with mediastinal mass in chest radiography underwent biopsy of mediastinal lesions by either cervical mediastinoscopy (n=69) or parasternal mediastionoscopy (n=28). We also analyzed the correlation of symptoms, location and extent of the lesion with the pathologic diagnosis. Results All 97 patients recovered smoothly without postoperative complications. Histologic diagnosis was obtained in 96 patients. Patients with hoarse, dysphagia and superior vena cava obstruction syndrome indicate malignant lesions (26/26). The most common diseases in the super-anterior mediastinum are lymphoma(7/19), thymoma(4/19) and small cell lung cancer(SCLC) (4/19);The most common disease in the middle mediastinum are metastasis of non small cell lung cancer(11/37), sarcoidosis (9/37)and SCLC(7/37); The most possible disease involved both mediastinum and lung hilar lymph-node are scalerdosis(32/41) and SCLC(5/41). Conclusion Mediastinoscopy is effective and safe methods to establish a histologic diagnosis in patients with mediastinal mass. It is possible to make primary evaluation on some of these patients according to the typical symptoms and location, extent of the mass involvement.