Mesothelioma Diagnosis: Mediastinoscopy

A mediastinoscopy is a surgical procedure that is used to examine the mediastinum, which is the area inside the upper chest, between and in front of the lungs. A device known as a mediastinoscope examines the area and can extract tissue samples for biopsy. Mediastinoscopy is often used to examine lymph nodes for evidence of nodal metastases.

Purpose

By examining the mediastinum doctors can check for certain lung or pleural diseases and observe their progression should a disease be diagnosed.  If pleural mesothelioma, or another form of cancer, is identified doctors may biopsy the lymph nodes in the mediastinum to investigate if the cancer has spread past its place of origin.  An identification of cancer cells in the lymph nodes is always indicative of a more advanced stage of the disease.

Mediastinoscopy and Mesothelioma Diagnosis

A biopsy may be taken during a mediastinoscopy to determine if a person has lung cancer or pleural mesothelioma. When mesothelioma is suspected, the physician is likely to biopsy both pleural tissues and surrounding lymph nodes. A mediastinoscopy will also allow doctors to check if the disease has spread beyond the pleural surfaces into adjacent tissue structures.

Along with its diagnostic uses, mediastinoscopy is also useful for staging and treatment purposes. The information gathered from the analysis of pleural surfaces, lymph nodes and surrounding tissues helps doctors to identify a patient’s disease status and to determine which type of treatments are most appropriate.

Preparation

Patients should not eat or drink after midnight on the night before surgery.  Doctors should be notified of any and all allergies and medications being used.

Procedure

Patients undergoing the procedure are given a general anesthesia.  A small incision is made just below the neck or at the notch at the top of the breastbone. This incision is used to insert the mediastinoscope which allows the surgeon to see inside the chest cavity as well as perform biopsies. If a biopsy is taken, the tissue sample will be sent to a lab to test for cancer or other diseases.

The entire procedure generally takes an hour to perform.

Risks

Complications from mediastinoscopy may include a collapsed lung, an esophageal tear, bleeding or infection.

After Care

Some patients recover within hours following a mediastinoscopy while others may take one to two days.  Patients should contact their doctor if they experience any pain in the chest area or if the incision displays signs of infection.