Mediastinoscopy in Assessing Mediastinal Lymphadenopathy and Lung Disease

Background: Mediastinoscopy is the gold standard procedure for the pathological staging and diagnosis of mediastinal diseases. The aim of the study is to describe the significance of anterior cervical Mediastinoscopy in evaluating patients with mediastinal lymphadenopathy and lung parenchymal disease. Material and Methods: From January 2014 until June 2017 we conducted a retrospective study of 52 consecutive patients with mediastinal lymphadenopathy and lung parenchymal disease who underwent anterior cervical Mediastinoscopy. The main indications for cervical Mediastinoscopy were isolated mediastinal lymphadenopathy, undetermined lung mass with mediastinal lymphadenopathy, and the clinical staging of patients with lung cancer. Results: The study subjects consisted of 37 men and 15 women, aged 13 to 87 (mean age 50.8). Eight patients had mediastinoscopy for staging lung cancer, 27 patients had mediastinoscopy to diagnose isolated mediastinal lymphadenopathy, and 17 patients had mediastinoscopy for an undetermined lung parenchymal mass. Among the patients with isolated mediastinal lymphadenopathy, sarcoidosis was diagnosed in 6, tuberculosis in 9, reactive lymph nodes in 4, metastasis in 5 and lymphoma in 3. Lymph node metastasis (N2, N3) was found in 5 patients with lung cancer. There was no surgical-related mortality or morbidity. Conclusions: Mediastinoscopy is a safe and reliable procedure in diagnosing mediastinal diseases and is still the first choice among the investigative modalities in the clinical staging of bronchogenic carcinoma.

Mediastinoscopy after stent implantation： a good method for diagnosis and treatment of severe superior vena cava syndrome

Superior vena cava syndrome （SVCS） is a clinical syndrome caused by compression or invasion of the superior vena cava or thrombus formation within the superior vena cava.SVCS is typically the most common emergency associated with tumors.The rapid progression of the disease necessitates immediate treatment.

Natural orifice transesophageal thoracoscopic surgery:A review of the current state

Since the concept of Natural Orifice Translumenal Endoscopic Surgery(NOTES) was introduced,it has continued to gain significantly in popularity and enthusiasm for its potential clinical applications.The ability to perform conventional laparoscopic and thoracoscopic procedures without the creation of scars and perhaps faster and less painful recovery has prompted a worldwide devotion to further this field.While intraabdominal NOTES has rapidly transitioned from animal models to human trials,applying the NOTES concept to perform thoracic procedures has been slower to gain momentum.The goal of this review is to summarize the current state of transesophageal NOTES thoracoscopy by looking at its potential for diagnostic and therapeutic interventions as well as the challenges in transitioning to human trials.

Mantle cell lymphoma with endobronchial involvement:A case report

BACKGROUND Mantle cell lymphoma(MCL)is a subtype of Non-Hodgkin’s lymphoma(NHL).MCL frequently affects extranodal sites while endobronchial involvement is uncommon.Only 5 cases of MCL with endobronchial involvement have been previously reported.CASE SUMMARY A 56-year-old male patient arrived at the hospital complaining of a dry cough.A mass in the right upper lobe of the lung was revealed in Chest computed tomography(CT).Right lung hilar and mediastinal lymphadenopathies were also found by CT scan.The patient was diagnosed with central-type lung cancer with multiple lymph node metastases after positron emission tomography(PET)CT scan examination.The fiber optic bronchoscope examination revealed diffuse neoplasm infiltration in the inlet of the right up lobar bronchus.The patient was finally diagnosed with MCL based on the bronchoscopy and mediastinoscopy biopsy results.CONCLUSION MCL could masquerade as central type lung cancer.An endobronchial biopsy examination is necessary for the early diagnosis of MCL.