Diagnostic modalities in the mediastinum and the role of bronchoscopy in mediastinal assessment: a narrative review.

Journal: Mediastinum (Hong Kong, China)
Published Date: Dec 6, 2024

Abstract

BACKGROUND AND OBJECTIVE: Diagnosis of pathology in the mediastinum has proven quite challenging, given the wide variability of both benign and malignant diseases that affect a diverse array of structures. This complexity has led to the development of many different non-invasive and invasive diagnostic modalities. Historically, diagnosis of the mediastinum has relied on different imaging modalities such as chest X-ray, computed tomography (CT), magnetic resonance imaging, and positron emission topography. Once a suspicious lesion was identified with one of these techniques, the gold standard for diagnosis was mediastinoscopy for diagnosis and staging of disease. More recently, many minimally invasive techniques such as CT-guided biopsy, endobronchial ultrasound with transbronchial needle aspiration, and endoscopic ultrasound with fine needle aspiration have revolutionized the diagnosis of the mediastinum. This review provides a comprehensive analysis of all the modalities available for diagnosing mediastinal disease with an emphasis on bronchoscopic techniques.

Authors

  • Yonatan Dollin
    Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA, USA.
  • Jorge A Munoz Pineda
    Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA, USA.
  • Lily Sung
    Departement of Radiology, University of California San Diego, San Diego, CA, USA.
  • Farnaz Hasteh
    Division of Pathology, University of California San Diego, San Diego, CA, USA.
  • Monica Fortich
    Division of Internal Medicine, University of California San Diego, San Diego, CA, USA.
  • Amanda Lopez
    Division of Internal Medicine, University of California San Diego, San Diego, CA, USA.
  • Keriann Van Nostrand
    Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA, USA.
  • Niral M Patel
    Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA, USA.
  • Russell Miller
    Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA, USA.
  • George Cheng
    Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA, USA.

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