The Annals of Thoracic Surgery, Vol 44, 238-241, Copyright © 1987 by The Society of Thoracic Surgeons
Standard biplane roentgenography is highly sensitive in documenting mediastinal masses
GJ Harris, PK Harman, JK Trinkle and FL Grover
The records of 30 patients with mediastinal masses were reviewed to
evaluate the signs, symptoms, and preoperative tests that were most useful
in diagnosing and localizing the masses. Sixteen (53%) of the tumors were
benign, and 14 (47%) were malignant. Twenty patients were seen with
symptoms. The most common symptoms suggesting malignancy were pain, weight
loss, fever, and cough. Four of the 5 patients who were truly asymptomatic
had benign lesions. All 4 patients with palpable adenopathy had malignant
tumors. Posteroanterior and lateral chest roentgenograms detected the
mediastinal mass in 29 (97%) of the 30 patients. All patients were operated
on for tissue diagnosis or resection (13, median sternotomy; 8, right
thoracotomy; 3, left thoracotomy; 2, low anterior cervical approach). Eight
patients underwent mediastinoscopy, which was diagnostic in 6 and obviated
the need for operation in 4. It was of particular value for patients with
lymphoma, who can be managed without resection.
