Diagnostic approaches to the mediastinum

ABSTRACT

The evaluation and treatment of mediastinal lesions requires a thorough acquaintance with the diagnostic approach or combination of approaches to the mediastinum. In the present series this entailed the study of 136 patients submitted to different diagnostic approaches. CT scanning and anterior mediastinotomy yielded the best diagnostic results. CT-guided needle biopsy and transtracheal mediastinal lymphography were less conclusive, but definitely helpful tools. Mediastinoscopy is still considered helpful in the evaluation of lesions in the posterior part of the superior mediastinum. Scalene lymph node biopsy remains to have its attraction in view of its simplicity and practically absence of morbidity. The merits and demerits of each of these diagnostic tools are discussed in this article