Table of ContentsView AllTable of ContentsDefinitionStructureConditionsMassesTermsMediastinoscopyFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Definition
Structure
Conditions
Masses
Terms
Mediastinoscopy
Frequently Asked Questions
The mediastinum is an important region of the body located between the lungs. Structures that lie in this region include the heart, the esophagus, the trachea, and large blood vessels including the aorta. The mediastinum is also home to lymph nodes.
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There are many conditions that can affect the mediastinum or the mediastinal lymph nodes, including cancer, benign tumors, infections, and more. Understanding the different parts of the mediastinum is very helpful in determining the causes of abnormalities in this region. Let’s take a look at the different parts of the mediastinum and the conditions that may occur in each area.
Definition of Mediastinum
The mediastinum is the area in the chest between the lungs that contains the heart, part of the windpipe (thetrachea), theesophagus, and the great vessels including the ascending aorta (the large artery which carries blood from the left ventricle of the heart on its way to the rest of the body) and right and left pulmonary arteries—essentially all of the organs in the chest except the lungs. It is also home to manylymph nodesand nerves.
The word mediastinum is translated as “midway” in Latin, in reference to the middle part of the chest.
The mediastinum can be thought of as having two regions, the top, and bottom. The bottom (inferior) half is divided into three main regions. Even though this may sound like a boring description of anatomy, understanding the structures that lie in each of these areas is very important in diagnosing medical conditions in this region.
Conditions Affecting the Mediastinum
There are many medical conditions which can affect structures in the mediastinum, and early on, most of these conditions do not have symptoms. Some of these include:
Mediastinal Masses
Mediastinal masses are often first noted when a scan is done to evaluate symptoms related to the chest, such as a cough, shortness of breath, or other symptoms. Most masses in the mediastinum are small and do not have any symptoms. When they are large, they can cause respiratory insufficiency (difficulty breathing or getting enough oxygen to the tissues) as well as heart problems, such as a drop in blood pressure or decreased blood flow.
The age of an individual and the location of a mediastinal mass are important in considering a diagnosis. In children, mediastinal masses occur most often in the posterior mediastinum and are often benign (noncancerous). In contrast, mediastinal masses in adults are more common in the anterior mediastinum and often malignant (cancerous.)
Some causes of mediastinal masses based on location include:
Lung cancer may cause a mass in any part of the mediastinum.
It’s important to note that there are many more causes of abnormalities in the mediastinum, and most often further testing is needed to define the exact cause.
Terms Involving the Mediastinum
The mediastinum may also be included in names of conditions involving this region, such as:
Mediastinoscopy Procedure
With cancers such as lung cancer and lymphomas, doctors often evaluate the mediastinum to see if any cancer has spread to this region. One procedure that allows surgeons to visualize this area is called amediastinoscopy. If a cancer has spread to nodes in the mediastinum, it is often treated differently than a cancer that has not spread to this region; the presence of mediastinal lymph nodes is important in the staging of lung cancer.
Mediastinoscopy was a common procedure for those diagnosed with lung cancer, but the same information may sometimes be available now via a PET scan.
Examples:Joy had a procedure done to see if her lung cancer had spread to lymph nodes in her mediastinum.
Frequently Asked QuestionsThe mediastinum is located inside the thoracic cavity (the chest area) between the lungs. It is divided into four compartments: the superior, anterior, middle, and posterior. Each one houses different structures such as the heart and arteries.The heart is located within the middle mediastinum, alongside many blood vessels and lymph nodes. The middle mediastinum is its largest compartment.The posterior mediastinum houses the esophagus, the descending thoracic aorta, veins, and nerves.
The mediastinum is located inside the thoracic cavity (the chest area) between the lungs. It is divided into four compartments: the superior, anterior, middle, and posterior. Each one houses different structures such as the heart and arteries.
The heart is located within the middle mediastinum, alongside many blood vessels and lymph nodes. The middle mediastinum is its largest compartment.
The posterior mediastinum houses the esophagus, the descending thoracic aorta, veins, and nerves.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Terán MD, Brock MV.Staging lymph node metastases from lung cancer in the mediastinum.J Thorac Dis. 2014;6(3):230-6. doi:10.3978/j.issn.2072-1439.2013.12.18Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L.A diagnostic approach to the mediastinal masses.Insights Imaging. 2013;4(1):29-52. doi:10.1007/s13244-012-0201-0Lee AY, Choi SJ, Jung KP, Park JS, Lee SM, Bae SK.Characteristics of Metastatic Mediastinal Lymph Nodes of Non-Small Cell Lung Cancer on Preoperative F-18 FDG PET/CT.Nucl Med Mol Imaging. 2014;48(1):41-6. doi:10.1007/s13139-013-0244-2Tiwari MK, Yadav R, Mathur RM, Shrivastava CP.Mediastinal bronchogenic cyst presenting with dysphagia and back pain.Lung India. 2010;27(2):86-8. doi:10.4103/0970-2113.63612Kouritas VK, Papagiannopoulos K, Lazaridis G, et al.Pneumomediastinum.J Thorac Dis. 2015;7(Suppl 1):S44-9. doi:10.3978/j.issn.2072-1439.2015.01.11Mclean AEB, Barnes DJ, Troy LK.Diagnosing Lung Cancer: The Complexities of Obtaining a Tissue Diagnosis in the Era of Minimally Invasive and Personalised Medicine.J Clin Med. 2018;7(7). doi:10.3390/jcm7070163Stoddard N, Heil JR, Lowery DR.Anatomy, thorax, mediastinum. StatPearls.Additional ReadingBarrington, S., and R. Kluge.FDB PET for Therapy Monitoring in Hodgkin and Non-Hodgkin Lymphomas.European Journal of Nuclear Medicine and Molecular Imaging. 2017;44(Suppl 1):97-110. doi:10.1007/s00259-017-3690-8Berry, M. Evaluation of Mediastinal Masses. UpToDate.Li, W., van Boven, W., Annema, J., Eberl, S., Klomp, H. and B de Mol.Management of Large Mediastinal Masses: Surgical and Anesthesiological Considerations.Journal of Thoracic Disease. 2016. 8(3):E175-84.U.S. National Library of Medicine. Medline Plus.Mediastinal Tumors.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Terán MD, Brock MV.Staging lymph node metastases from lung cancer in the mediastinum.J Thorac Dis. 2014;6(3):230-6. doi:10.3978/j.issn.2072-1439.2013.12.18Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L.A diagnostic approach to the mediastinal masses.Insights Imaging. 2013;4(1):29-52. doi:10.1007/s13244-012-0201-0Lee AY, Choi SJ, Jung KP, Park JS, Lee SM, Bae SK.Characteristics of Metastatic Mediastinal Lymph Nodes of Non-Small Cell Lung Cancer on Preoperative F-18 FDG PET/CT.Nucl Med Mol Imaging. 2014;48(1):41-6. doi:10.1007/s13139-013-0244-2Tiwari MK, Yadav R, Mathur RM, Shrivastava CP.Mediastinal bronchogenic cyst presenting with dysphagia and back pain.Lung India. 2010;27(2):86-8. doi:10.4103/0970-2113.63612Kouritas VK, Papagiannopoulos K, Lazaridis G, et al.Pneumomediastinum.J Thorac Dis. 2015;7(Suppl 1):S44-9. doi:10.3978/j.issn.2072-1439.2015.01.11Mclean AEB, Barnes DJ, Troy LK.Diagnosing Lung Cancer: The Complexities of Obtaining a Tissue Diagnosis in the Era of Minimally Invasive and Personalised Medicine.J Clin Med. 2018;7(7). doi:10.3390/jcm7070163Stoddard N, Heil JR, Lowery DR.Anatomy, thorax, mediastinum. StatPearls.Additional ReadingBarrington, S., and R. Kluge.FDB PET for Therapy Monitoring in Hodgkin and Non-Hodgkin Lymphomas.European Journal of Nuclear Medicine and Molecular Imaging. 2017;44(Suppl 1):97-110. doi:10.1007/s00259-017-3690-8Berry, M. Evaluation of Mediastinal Masses. UpToDate.Li, W., van Boven, W., Annema, J., Eberl, S., Klomp, H. and B de Mol.Management of Large Mediastinal Masses: Surgical and Anesthesiological Considerations.Journal of Thoracic Disease. 2016. 8(3):E175-84.U.S. National Library of Medicine. Medline Plus.Mediastinal Tumors.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Terán MD, Brock MV.Staging lymph node metastases from lung cancer in the mediastinum.J Thorac Dis. 2014;6(3):230-6. doi:10.3978/j.issn.2072-1439.2013.12.18Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L.A diagnostic approach to the mediastinal masses.Insights Imaging. 2013;4(1):29-52. doi:10.1007/s13244-012-0201-0Lee AY, Choi SJ, Jung KP, Park JS, Lee SM, Bae SK.Characteristics of Metastatic Mediastinal Lymph Nodes of Non-Small Cell Lung Cancer on Preoperative F-18 FDG PET/CT.Nucl Med Mol Imaging. 2014;48(1):41-6. doi:10.1007/s13139-013-0244-2Tiwari MK, Yadav R, Mathur RM, Shrivastava CP.Mediastinal bronchogenic cyst presenting with dysphagia and back pain.Lung India. 2010;27(2):86-8. doi:10.4103/0970-2113.63612Kouritas VK, Papagiannopoulos K, Lazaridis G, et al.Pneumomediastinum.J Thorac Dis. 2015;7(Suppl 1):S44-9. doi:10.3978/j.issn.2072-1439.2015.01.11Mclean AEB, Barnes DJ, Troy LK.Diagnosing Lung Cancer: The Complexities of Obtaining a Tissue Diagnosis in the Era of Minimally Invasive and Personalised Medicine.J Clin Med. 2018;7(7). doi:10.3390/jcm7070163Stoddard N, Heil JR, Lowery DR.Anatomy, thorax, mediastinum. StatPearls.
Terán MD, Brock MV.Staging lymph node metastases from lung cancer in the mediastinum.J Thorac Dis. 2014;6(3):230-6. doi:10.3978/j.issn.2072-1439.2013.12.18
Juanpere S, Cañete N, Ortuño P, Martínez S, Sanchez G, Bernado L.A diagnostic approach to the mediastinal masses.Insights Imaging. 2013;4(1):29-52. doi:10.1007/s13244-012-0201-0
Lee AY, Choi SJ, Jung KP, Park JS, Lee SM, Bae SK.Characteristics of Metastatic Mediastinal Lymph Nodes of Non-Small Cell Lung Cancer on Preoperative F-18 FDG PET/CT.Nucl Med Mol Imaging. 2014;48(1):41-6. doi:10.1007/s13139-013-0244-2
Tiwari MK, Yadav R, Mathur RM, Shrivastava CP.Mediastinal bronchogenic cyst presenting with dysphagia and back pain.Lung India. 2010;27(2):86-8. doi:10.4103/0970-2113.63612
Kouritas VK, Papagiannopoulos K, Lazaridis G, et al.Pneumomediastinum.J Thorac Dis. 2015;7(Suppl 1):S44-9. doi:10.3978/j.issn.2072-1439.2015.01.11
Mclean AEB, Barnes DJ, Troy LK.Diagnosing Lung Cancer: The Complexities of Obtaining a Tissue Diagnosis in the Era of Minimally Invasive and Personalised Medicine.J Clin Med. 2018;7(7). doi:10.3390/jcm7070163
Stoddard N, Heil JR, Lowery DR.Anatomy, thorax, mediastinum. StatPearls.
Barrington, S., and R. Kluge.FDB PET for Therapy Monitoring in Hodgkin and Non-Hodgkin Lymphomas.European Journal of Nuclear Medicine and Molecular Imaging. 2017;44(Suppl 1):97-110. doi:10.1007/s00259-017-3690-8Berry, M. Evaluation of Mediastinal Masses. UpToDate.Li, W., van Boven, W., Annema, J., Eberl, S., Klomp, H. and B de Mol.Management of Large Mediastinal Masses: Surgical and Anesthesiological Considerations.Journal of Thoracic Disease. 2016. 8(3):E175-84.U.S. National Library of Medicine. Medline Plus.Mediastinal Tumors.
Barrington, S., and R. Kluge.FDB PET for Therapy Monitoring in Hodgkin and Non-Hodgkin Lymphomas.European Journal of Nuclear Medicine and Molecular Imaging. 2017;44(Suppl 1):97-110. doi:10.1007/s00259-017-3690-8
Berry, M. Evaluation of Mediastinal Masses. UpToDate.
Li, W., van Boven, W., Annema, J., Eberl, S., Klomp, H. and B de Mol.Management of Large Mediastinal Masses: Surgical and Anesthesiological Considerations.Journal of Thoracic Disease. 2016. 8(3):E175-84.
U.S. National Library of Medicine. Medline Plus.Mediastinal Tumors.
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