Volume 30, Issue 4 (Avicenna Journal of Clinical Medicine-Winter 2024)                   Avicenna J Clin Med 2024, 30(4): 212-217 | Back to browse issues page

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1- Department of Surgery, Clinical Research Development Unit, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran.
2- Department of Surgery, School of Medicine, Babol University of Medical Sciences, Babol, Iran
3- Department of Biostatistics, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
4- Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran , novinsu@hotmail.com
Abstract:   (379 Views)
Background and Objective: One of the most important steps in the treatment of patients with mediastinal lymphadenopathy is the definitive diagnosis using tissue sampling of the intra-mediastinal lesion. Mediastinoscopy is one of the methods used for this purpose. In this regard, this study aims to investigate the role of mediastinoscopy in determining the cause of mediastinal lymphadenopathy in patients referred to Shahid Beheshti Hospital in Babol, Iran.
Materials and Methods: This cross-sectional study was conducted on 36 patients with mediastinal lymphadenopathy who were admitted to Shahid Beheshti Hospital in Babol (April 2009-March 2020) and underwent mediastinoscopy. Recorded medical information of all patients without known lung cancer under mediastinoscopy was reviewed. Mediastinoscopy was performed by a specialist doctor for all patients and the biopsy sample was sent to Shahid Beheshti Hospital Pathology for final diagnosis. Descriptive data were analyzed using SPSS25 software at a significance level of 0.05.
Results: The mean age of the patients was 47.97±11.04 years (range: 28-76 years). The majority of patients were women (n=27; 75.00%). According to the pathology results, the final diagnosis for 33 people (91.67%) was benign, and 3 people (8.33%) were diagnosed with malignant. The most common pathology result was sarcoidosis with 23 cases (63.90%), active infection in 4 cases (11.11%), and squamous cell carcinoma in 3 cases (8.33%). Other benign results were reported with the frequency of one case (78.2%). Pathology findings had no significant relationship with the age and gender of patients (P<0.05).
Conclusion: Based on the findings of the study, it can be concluded that mediastinoscopy can help determine the causes of mediastinal lymphadenopathy and it is still a reliable method for examining mediastinal lesions.
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Type of Study: Original | Subject: General Surgery

1. Deng CJ, Dai FQ, Qian K, Tan QY, Wang RW, Deng B, et al. Clinical updates of approaches for biopsy of pulmonary lesions based on systematic review. BMC Pulm Med. 2018;18(1):146. PMID: 30176840 DOI: 10.1186/s12890-018-0713-6
2. Harken DE, Black H, Clauss R, Farrand RE. A simple cervicomediastinal exploration for tissue diagnosis of intrathoracic disease; with comments on the recognition of inoperable carcinoma of the lung. N Engl J Med. 1954;251(26):1041-4. PMID: 13214387 DOI: 10.1056/NEJM195412232512602
3. Chauhan A, Kapoor S, Ganguly M, Nath P. Cervical mediastinoscopy: re-evaluation of an old technique in era of new imaging technology. Indian J Chest Dis Allied Sci. 2012;54(3):169-73.
4. Khorshidi H, Tarbiat M, Moradi A, Karimi B. Assesment of Mediastinoscopy Surgery Results in Patients with Mediastinal Tumor Reffered to Besat Hospital in Hamadan City from 2014 to 2019. Avicenna J Clin Med. 2020; 27 (2) :94-99. DOI: 10.29252/ajcm.27.2.94
5. Samet JM. Smoking kills: experimental proof from the Lung Health Study. Ann Intern Med. 2005;142(4):299-301. PMID: 15710963 DOI: 10.7326/0003-4819-142-4-200502150-00012
6. Silvestri G, Gould M, Margolis M, Tanoue L, McCrory D, Toloza E. Noninvasive staging of non-small cell lung cancer: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest. 2007;132(3 Suppl): 178S-201S. PMID: 17873168 DOI: 10.1378/chest.07-1360
7. Carlens E. Mediastinoscopy: a method for inspection and tissue biopsy in the superior mediastinum. Dis Chest. 1959;36:343-52. PMID: 13807712 DOI: 10.1378/chest.36.4.343
8. Hammoud ZT, Anderson RC, Meyers BF, Guthrie TJ, Roper CL, Cooper JD, et al. The current role of mediastinoscopy in the evaluation of thoracic disease. J Thorac Cardiovasc Surg. 1999;118(5):894-9. PMID: 10534695 DOI: 10.1016/s0022-5223(99)70059-0
9. Harewood GC, Wiersema MJ, Edell ES, Liebow M. Cost-minimization analysis of alternative diagnostic approaches in a modeled patient with non-small cell lung cancer and subcarinal lymphadenopathy. Mayo Clinic proceedings. 2002;77(2):155-64. DOI: 10.4065/77.2.155
10. Goldstraw P, Kurzer M, Edwards D. Preoperative staging of lung cancer: accuracy of computed tomography versus mediastinoscopy. Thorax. 1983;38(1):10-5. PMID: 6845256 DOI: 10.1136/thx.38.1.10
11. Serna DL, Aryan HE, Chang KJ, Brenner M, Tran LM, Chen JC. An early comparison between endoscopic ultrasound-guided fine-needle aspiration and mediastinoscopy for diagnosis of mediastinal malignancy. Am Surg. 1998;64(10):1014-8. PMID: 9764715
12. Ghigna M, de Montpreville V. Mediastinal tumours and pseudo-tumours: a comprehensive review with emphasis on multidisciplinary approach. Eur Respir Rev. 2021;30(162):200309. PMID: 34615701 DOI: 10.1183/16000617.0309-2020
13. Shields TW. General thoracic surgery: Lippincott Williams & Wilkins. 2005.
14. Eldaboosy SA, Zeinnhom RA, Kanany H, Nour MO. The value of cervical mediastinoscopy in the diagnosis of mediastinal lesions. Egypt J Chest Dis Tuberc. 2015;64(3):755-60. DOI: 10.1016/j.ejcdt.2015.03.030
15. Zhu F, Ma D-C, Xu N, Xu X-Q, Lv L-P, Tang L, et al. Diagnostic Value of Video-assisted Mediastinoscopy and Endobronchial Ultrasound-guided Transbronchial Needle Aspiration for Mediastinal Lymphadenectasis without Pulmonary Abnormalities. Med Sci Monit. 2017;23:3064-3070. PMID: 28642455 DOI: 10.12659/msm.900968
16. Onat S, Ates G, Avcı A, Yıldız T, Birak A, Akgul Ozmen C, et al. The role of mediastinoscopy in the diagnosis of non-lung cancer diseases. Ther Clin Risk Manag. 2017;13:939-943. PMID: 28794637 DOI: 10.2147/TCRM.S144393
17. Glick RD, La Quaglia MP, editors. Lymphomas of the anterior mediastinum. Semin Pediatr Surg. 1999;8(2):69-77. PMID: 10344303 DOI: 10.1016/s1055-8586(99)70021-1
18. Valizadeh N, Farrokhi F, Mehdiughli M, Eishi Oskuie A, Oshnouei S, Noroozinia F. Etiologic assessment of mediastinal masses in patients of Emam Khomeinihospital in Urmia, Iran. Stud Med Sci. 2014; 24(12):1036-9.
19. JAhanshahi A, Aalamshah S. Epidemiology of mediastinal masses during five years (1382-1387) in Ahvaz. 2009.
20. Ahmadi J, Kalantari M, Raeis Alsadat, Mehrabi V, Nahvi H. A review of mediastinal tumors in children. Tehran Univ Med J 2004; 62 (4) :345-350
21. Vaziri M, Pazooki A, Zahedi-Shoolami L. Mediastinal masses: review of 105 cases. Acta Medica Iranica. 2009:297-300.

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