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NewYork-Presbyterian/Weill Cornell Medical Center - Center for Advanced Digestive Care

NewYork-Presbyterian/Weill Cornell Medical Center - Center for Advanced Digestive Care

Mediastinal Lesions/Masses

What are mediastinal lesions/masses?

The mediastinum is the middle section of the chest cavity. It contains many vital structures, such as the heart, great vessels, esophagus, and trachea. The types of lesions and masses found in the mediastinum can vary depending on where they are located (anterior/front compartment, the middle mediastinum, or the posterior/back compartment). Lesions and masses in the mediastinum can be benign or malignant. Tumors and cysts found in the mediastinum result from a variety of causes.

Mediastinal Cysts

Various types of cysts can originate in the mediastinum. Although they are not actually tumors, they may compress surrounding structures and cause symptoms. They most often result from abnormal embryologic development (abnormalities that form when an embryo is first developing in the mother's uterus). Examples of mediastinal cysts include foregut cysts, gastroenteric cysts, neurenteric cysts, mesothelial cysts, and bronchogenic cysts. Most of these abnormalities are considered benign. However, there have been reported cases in which malignant tissue (squamous cell carcinoma and adenocarcinoma) has been found within the wall of a surgically removed bronchogenic cyst.

Mediastinal masses

Masses that may develop in the mediastinum include neuroendocrine tumors as well as those related to esophageal cancer and lung cancer.

What symptoms are associated with this condition?

Signs and symptoms associated with mediastinal masses and lesions vary according to the location of the mass. For example, a mass compressing the airway can lead to lung infection or hemoptysis (coughing up blood), while a mass compressing the esophagus can cause dysphagia (difficulty swallowing).

How are they diagnosed?

Mediastinal masses are usually found "incidentally" by radiologic methods such as chest radiographs (x-ray), computed tomography (CT), or magnetic resonance imaging (MRI) that was being done for other reasons.

To better determine which type of mass you have, our team of advanced endoscopists uses a technology known as endoscopic ultrasound (EUS). This technology makes it possible to visualize the lesion in fine detail within the mediastinum using an ultrasound device located at the tip of an endoscope. It provides real-time, close-up images of the mass. EUS also makes it possible to take samples (biopsies) of the mass with fine-needle aspiration (FNA). The tissue sampling is safe and is accomplished with a small needle inserted through the channel of the endoscope.

For more about these procedures, visit the Advanced Interventional Endoscopy page.

Mediastinal lymph nodes

Inflammation, infection, or cancer can affect the mediastinal lymph nodes. EUS plus fine-needle aspiration is an effective means of sampling lymph nodes from the esophagus and offers a less invasive approach than surgical biopsy. This approach can enhance the staging of lung cancer and can be performed in conjunction with a biopsy from the bronchus.

How can I make an appointment to see an advanced endoscopist?

Our specialists are experienced in diagnosing and treating mediastinal lesions and masses. An interdisciplinary team of gastrointestinal specialists in endoscopy, radiology, and surgery work together as a team to provide each patient with coordinated, advanced, and individualized care. Please contact our Advanced Interventional Endoscopy team to discuss your case.