Mediastinoscopy

A mediastinoscopy is a test to examine the space in the chest between the lungs (mediastinum) using an endoscope (a thin, tube-like instrument with a light and lens).

Why a mediastinoscopy is done

A mediastinoscopy is done to:

• identify certain infections or inflammation
• diagnose lung diseases or tumours
• see if cancer has spread to lymph nodes in the mediastinum
• biopsy mediastinal lymph nodes or abnormal growths in the mediastinum
• help stage lung cancer and determine if lung tumours are operable or not

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How a mediastinoscopy is done

• Preparation for a mediastinoscopy can vary but usually includes:
  • Do not eat or drink anything for at least 8 hours before the test.
• A mediastinoscopy is done in a hospital operating room. Some people may be able to go home the same day as the procedure once they can swallow, but need to arrange for a ride home.
• A mediastinoscopy is done while the person is under general anesthetic.
• A mediastinoscope is put through a small cut (incision) at the base of the neck, just above the breastbone. The mediastinoscope is inserted into the middle part of the chest along the windpipe (trachea).
• Samples of cells or tissue are taken from the lymph nodes or from other suspicious areas in the mediastinum.
• The mediastinoscope is then removed and the incision is closed with stitches and covered with a bandage.
• There will be some discomfort or tenderness at the incision site and neck after the procedure.

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Potential side effects

The risks from mediastinoscopy are:

• sore throat or trouble swallowing
• bleeding
• hoarseness – can be caused by injury to a nerve near the voice box (larynx)
• swelling of the neck
• infection
• breathing difficulties
• low blood oxygen level
• buildup of air in the space between the lungs and the wall of the chest that causes the lung to partially or completely collapse (pneumothorax)
• blockage of a blood vessel due by an air bubble (air embolism)
• air from the chest cavity gets into the tissues under the skin of the chest, neck or face (subcutaneous emphysema)
• chest pain
• tear (puncture) in the trachea or esophagus
• damage to a blood vessel
• changes in blood pressure or heart rate

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What the results mean

A mediastinoscopy can show:

• enlarged or abnormal lymph nodes
• lung diseases, such as sarcoidosis and tuberculosis
• cancer, such as lung cancer, pleural mesothelioma and lymphoma

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What happens if a change or abnormality is found

The doctor will decide whether further tests, procedures, follow-up care or additional treatment is needed.

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