About the disease
Mediastinal lymphadenopathy is an enlargement of mediastinal lymph nodes. These lymph nodes are located in the mediastinum. Mediastinum is located in the chest right in the middle. It is surrounded by the lungs, the breastbone and the backbone and also by the diaphragm muscle. The mediastinum is sometimes referred to as a box, because it contains such vital organs as the heart, blood vessels, and lymph nodes. It also contains the nerves.
There are many causes which can lead to enlargement of lymph nodes in the mediastinum. It can develop as primary condition or appear as a result of other diseases, especially those that affect the lungs. People with obstructive pulmonary diseases are at risk of developing mediastinal lymphadenopathy. Also, having chronic and recurrent bronchitis can also lead to development of mediastinal lymphadenopathy. Some infections and inflammatory diseases, such as sarcoidosis, can also lead to development of mediastinal lymphadenopathy. Sarcoidosis is a collection of inflammatory cells. The most common location of this disease are lungs. In severe cases the mediastinal lymph nodes can become swollen as well. Tuberculosis can also lead to enlargement of these lymph nodes.
In rare cases mediastinal lymphadenopathy can be an indicator of cancer. If swollen lymph nodes are indeed cancerous, it can be the indicator of either lymphoma or lung cancer. Lymphoma is cancer of white blood cells. When it develops, the lymph nodes can become swollen and inflamed. Lung cancer in its progressed form can metastasize to mediastinal lymph nodes if it had not been stopped on time.
Symptoms
- Pain in the chest
- Shortness of breath
- Tenderness
- Dizziness
- Vomiting
- Nausea
- Weakness
- Fatigue
Diagnosis
- During a general examination the doctor will examine the lungs first to rule out pulmonary diseases. The doctor will listen to the lungs and also to the heart to determine if both these organs function properly.
- The doctor will examine the medical history of the patient to determine if he/she had any pulmonary diseases in the past.
- Imaging tests, such as MRI or PET, are helpful in showing the mediastinum and determining if the lymph nodes in this area are swollen and enlarged. This tests are also helpful in determining if lungs function normally.
- A biopsy is used in some cases if there is a suspicion of malignancy The doctor obtains little sample of the lymph node from the mediastinum through the minimally invasive incision and examines it then in the laboratory.
Treatment
- Conservative treatment uses special medication and drugs that would reduce the inflammation of the lymph nodes and also reduce the pain.
- If mediastinal lymphadenopathy was caused by some pulmonary conditions, those condition need to be treated as well to avoid complications in the future and also avoid recurrence.
- Surgical removal of the inflamed lymph nodes is used in severe cases when this measure is absolutely necessary.
Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko
