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Least invasive modality, uses the esophagus to access mediastinal lymph nodes, excellent for station 5, 7, 8 lymph nodes. Useful for station 2L and 4L, L adrenal, celiac lymph node Cannot reliably access right sided paratracheal lymph node stations 2 R and 4R; accurate discrimination of primary hilar tumors and involved lymph nodes is important
Confirmation done by tissue biopsy of accompanying nodes if any, mediastinoscopy, mediastinotomy, or thoracotomy. FNA biopsy is usually not adequate. Treatment of mediastinal Hodgkin's involves chemotherapy and/or radiation. 5 year survival is now around 75%. Large-cell type may have somewhat better prognosis.
[29] [30] Lymph node staging depends on the extent of local spread: with the cancer metastasized to no lymph nodes (N0), pulmonary or hilar nodes (along the bronchi) on the same side as the tumor (N1), mediastinal or subcarinal lymph nodes (in the middle of the lungs, N2), or lymph nodes on the opposite side of the lung from the tumor (N3). [30]
Lung cancer/oesophageal cancer; Lymphangitis carcinomatosa; Cystic fibrosis; Histoplasmosis; Acute lymphoblastic leukemia; Coccidioidomycosis; Lymphoma [1] Whipple's disease [2] Goodpasture syndrome; Hypersensitivity pneumonitis; Inflammatory response to Silicone (leaked from ruptured implants) which has migrated and collected in mediastinal ...
Nx: lymph nodes cannot be assessed; N0: no regional lymph nodes metastasis; N1: regional lymph node metastasis present; at some sites, tumor spread to closest or small number of regional lymph nodes; N2: tumor spread to an extent between N1 and N3 (N2 is not used at all sites) N3: tumor spread to more distant or numerous regional lymph nodes ...
Whether a cancer is designated as Stage II or Stage III can depend on the specific type of cancer; for example, in Hodgkin's Disease, Stage II indicates affected lymph nodes on only one side of the diaphragm, whereas Stage III indicates affected lymph nodes above and below the diaphragm. The specific criteria for Stages II and III therefore ...
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