Mediastinal lymph nodes are organs located in the chest cavity. Lymph nodes are part of a network called the lymphatic system, which works to remove toxins and waste from the body. Sometimes, these lymph nodes can be affected by disease and therefore need to be analyzed for diagnosis.

In these cases, thoracic surgeons will perform a mediastinal lymph node biopsy. Mediastinal lymph node biopsy is a surgery done to collect a small tissue sample from a mediastinal lymph node that will then be used for analysis. The procedure is considered outpatient, because patients can typically go home the same day the surgery is performed. The surgery generally takes 60 to 90 minutes to complete, depending on the complexity of the diagnosis.

Why Mediastinal Lymph Node Biopsy Is Performed

Mediastinal lymph nodes constitute just a few of the hundreds of lymph nodes found throughout the body and are categorized as one of two types: anterior mediastinal lymph nodes and posterior mediastinal lymph nodes. Anterior mediastinal lymph nodes are located between the sternum and the heart, while posterior mediastinal lymph nodes are located between the heart and the spine. Their primary function is to help in the production of a type of white blood cell called, lymphocytes.

A mediastinal lymph node biopsy can help physicians:

  • Determine if lung cancer has metastasized
  • Structure an appropriate treatment plan
  • Diagnosis certain conditions, such as tuberculosis and sarcoidosis

What to Expect During a Mediastinal Lymph Node Biopsy Procedure

Patients will be placed under general anesthesia for the procedure. The surgeon will make a small incision close to the sternum or the breastbone. Next, a special instrument, called a mediastinoscope, is inserted through this incision into the chest cavity. A mediastinoscope is a flexible tube that has a light and a camera on the end. This device allows physicians to view and observe the chest cavity without having to make a larger incision and open the chest. Surgeries performed with the use of video are referred to as video-assisted thoracoscopic surgery or VATS. A sample of the tissue belonging to the mediastinal lymph nodes is carefully collected and the incision is sewn shut.

Risks Associated with Mediastinal Lymph Node Biopsy

Mediastinal lymph biopsies are often performed using non-invasive techniques, which pose fewer risks to the patient. However, any surgical procedure comes with at least minor risks. The risks associated with mediastinal lymph node biopsy include:

  • Puncture of certain organs and/or structures, such as the esophagus, the blood vessels, or the trachea, that can lead to bleeding
  • Infection
  • Pneumothorax (a collapsed lung)

Benefits of Mediastinal Lymph Node Biopsy

At MedStar Washington Hospital Center, our thoracic surgeons are experts in non-invasive surgical techniques for the diagnosis of tracheal disease. Non-invasive techniques offer patients the following benefits:

  • Shorter hospital stay following surgery
  • Smaller incisions compared to open surgical techniques
  • Less postoperative pain
  • Earlier return to daily activities compared to open surgical techniques

How to Prepare for Mediastinal Lymph Node Biopsy

Prior to mediastinal lymph node surgery, patients will be given specific instructions by the surgeon. Some of these instructions may include the following:

  • If necessary, stop taking certain medications prior to surgery
  • Do not eat or drink for eight hours, or as instructed, before the procedure

Post Mediastinal Lymph Node Biopsy Treatment

Patients who experience no complications immediately following surgery are typically allowed to return home a few hours after the procedure. Caregivers will give you instructions on how to clean the incision in order to prevent infection. It is important to attend all necessary follow-up appointments as instructed by the surgeon. Doing so will ensure proper healing of the operated area and decrease the risk of surgery-related complications.

Make an Appointment

For an appointment with a specialist, call 202-877-3627.