![]() ![]() Mediastinum endobronchial ultrasound lung cancer lymph node sarcoidosis tuberculosis. An accurate diagnosis translates into favorable treatment outcomes. Mediastinal granuloma is the abnormal enlargement of mediastinal lymph nodes by granulomatous inflammation, is usually asyptomatic or minimally symptomatic, and is often detected on chest radiographs taken for other reasons. The mediastinal lymph nodes are located in the region of the thoracic cavity between the lungs known as the mediastinum. These nodes play an important role in the filtration of lymph before it is returned to circulatory system. Endosonographic modalities (EBUS-TBNA, EUS-FNA, and EUS-B-FNA) have emerged as the cornerstone to most patients' diagnosis. Mediastinal granuloma/mediastinal fibrosis is a chronic inflammatory disease of the mediastinum. The mediastinal nodes are a group of lymph nodes located in the thoracic cavity of the body. Selecting an appropriate tissue diagnosis modality is crucial, with an intent to use the least invasive technique with good diagnostic yield. Treating physicians need to be aware of the clinico-radiological manifestations of the common diagnostic entities. Expert opinion: Mediastinal lymphadenopathy is a commonly encountered clinical problem. Regional lymph node classification for lung cancer staging adapted from the American Thoracic Society mapping scheme. Most of the mediastinal nodes are in close approximation to the left innominate vein, the anterior surface of the trachea, and circumference of the main bronchi, and inferior and to the left of the aortic arch 1. We discuss a practical approach toward the evaluation of a patient with mediastinal lymphadenopathy. Mediastinal lymph nodes are located in the anterior, middle, and posterior mediastinal compartments (figure 1 and figure 2). Areas covered: We performed a search of the PUBMED database to identify relevant articles on the causes, imaging modalities, and interventional modalities to diagnose these conditions. An accurate diagnosis is necessary for optimal management. For a confident diagnosis, the clinician must choose from several available options and integrate the clinical, radiological, and pathology findings. Malignancy (Lung cancer, lymphoma, and extrathoracic cancer) and granulomatous conditions (sarcoidosis and tuberculosis) are the most common causes. The initial clue to the presence of enlarged mediastinal lymph nodes is through thoracic imaging modalities. There is a variation in the underlying cause in different demographic settings. Introduction: Mediastinal lymphadenopathy is secondary to various benign and malignant etiologies. Enlarged mediastinal lymph nodes may be found incidentally, and guidelines for surveillance and evaluation can be found in the Journal of the American College of Radiology. ![]()
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