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Ann Thorac Surg 1974;18:531-538
© 1974 The Society of Thoracic Surgeons

Articles

Mediastinoscopy and Mediastinal Roentgenology: A Clinical Correlation

Edwin C. James, Lt, Col*, Robert A. Ellwood, MC, USA, Maj

Departments of Surgery and Radiology, Madigan Army Medical Center, Tacoma, Wash

Accepted for publication May 9, 1974.

* Address reprint requests to Dr. James, Chief, Thoracic Surgery Service, Department of Surgery, Madigan Army Medical Center, Tacoma, Wash. 98431

A retrospective analysis of the accuracy of mediastinal tomography in 70 consecutive patients undergoing mediastinoscopy is reported. The results clearly support the hypothesis that routine mediastinoscopy is not necessary for assessing the etiology or operability of indeterminate pulmonary lesions. Evidence for a pathological mediastinal abnormality is provided by noninvasive mediastinal tomography; both benign and malignant disease processes qualify. In bronchogenic carcinoma there was a 76.2% correlation between abnormal tomography and biopsy-positive mediastinoscopy. More significantly, there was a 95.4% correlation between normal tomography and negative biopsy. We submit that mediastinal tomography is of value in selecting patients for mediastinoscopy and in determining those who would best be deferred for thoracotomy.




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