Why It Is Done

This procedure is done to:

• Look for problems of the lungs and mediastinum, such as sarcoidosis.
• Diagnose lung cancer or lymphoma (including Hodgkin disease). It is often done to check lymph nodes to see if cancer has spread.
• Diagnose certain types of infection, such as tuberculosis.

How To Prepare

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Your doctor may order certain blood tests, such as a complete blood count or clotting factors, before your procedure.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options. Be sure to ask what may be done, such as lymph nodes being biopsied or removed, for each possible biopsy result.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your procedure. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.
• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.

How It Is Done

A small cut (incision) is made in the neck just above the breastbone or on the left side of the chest next to the breastbone. Then a thin scope (mediastinoscope) is inserted through the opening. Your doctor will look at the space in your chest between your lungs and heart. Lymph nodes or a tissue sample (biopsy) can be collected through the scope. The sample is then examined under a microscope for problems. These may include infection, inflammation, or cancer.

After the scope is taken out, the incision will be closed with a few stitches and covered with a bandage.

After the procedure, you will be taken to the recovery room. You may feel sleepy for several hours but can usually go home the same day.

How long the test takes

The entire procedure usually takes about an hour.

How It Feels

Before the procedure, you may be given medicine to relax you. You will then get general anesthesia, which will make you sleep.

Risks

Problems from mediastinoscopy aren't common. But they may include bleeding, infection, a collapsed lung, a tear in the esophagus, damage to a blood vessel, or injury to a nerve near the voice box (larynx) which may cause hoarseness.

Results

Normal

• Lymph nodes are small and smooth, and they appear normal.
• There are no growths, abnormal tissue, or signs of infection.

Abnormal

• Lymph nodes may be enlarged or appear abnormal. This may mean sarcoidosis, infection, or cancer.
• Abnormal growths (such as a tumor) or signs of infection (such as an abscess) may be found in the chest cavity, or mediastinum.