Introduction:
The cavity located between the lungs, breastbone, and spine constitutes the mediastinum. It comprises the windpipe or trachea, esophagus, heart, and blood vessels. Mediastinal diseases originate from these tissues in the cavity. It includes cysts, both cancerous and non-cancerous tumors. Mediastinal diseases are rare but life-threatening conditions. This is because the development of tumors causes pressure in the lungs, heart, and esophagus and interferes with their functional ability.
What Are the Causes of Mediastinal Disease?
There are various causes for mediastinal disease, depending on the origin. They are classified as follows;
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Lymphoma - It occurs in the front part of the mediastinum. Lymphocytes are a part of the immune system. The infection in these cells leads to tumor growth in the lymphatic system and causes lymphoma.
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Thymoma - It is a malignant disease that occurs on the surface of the thymus. The thymus organ is a part of the lymphatic system. The abnormal cells proliferate slowly and affect the thymus.
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Thyroid Mass - It is usually a benign condition. It occurs due to the enlargement of the thyroid gland present in the neck. The abnormal production of thyroid hormones leads to a condition called goiter.
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Bronchogenic Cyst - The abnormal growth of the tissue in the trachea or windpipe, bronchial tubes or air passages, and bronchioles or air sacs leads to the formation of fluid and causes a bronchogenic cyst.
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Lymphadenopathy Mediastinal - The enlargement of lymph nodes in the space between the lungs leads to lymphadenopathy mediastinal.
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Pericardial Cyst - It is a benign condition. It occurs due to abnormal growth from the outer lining of the heart called the pericardium. It is present in the center of the mediastinal space.
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Tracheal Tumors - The unusual proliferation of cancer cells in the trachea or windpipe leads to the formation of tracheal tumors.
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Esophageal Tumors - These occur due to the abnormal growth of tissue in the esophagus, which is a part of the digestive system. It can occur in the form of a benign or malignant tumor.
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Neurogenic Tumors - It is present behind the mediastinal space. The neoplasm or abnormal tissue growth in the nervous tissue present in the mediastinum leads to neurogenic tumors.
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Hematopoiesis - It is a rare condition. The abnormal growth formed due to the bone marrow expansion leads to hematopoiesis. Due to this, the patient is affected by anemia.
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Vertebral Abnormalities - The proliferation of tissues in the thoracic spine due to infection leads to a malignant condition in the spine.
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Aortic Aneurysm - The largest artery that carries oxygen from the heart to other organs is called the aorta. The enlargement of this blood vessel wall leads to an aortic aneurysm. It occurs near the chest area.
What Are the Symptoms of Mediastinal Disease?
Earlier stages of the mediastinal disease do not show any symptoms. The tumor is identified using the X-rays taken for other purposes. The various symptoms are as follows;
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If the abnormal cells proliferate to the air passages, it irritates the lining and produces a cough. Some patients expel blood while coughing.
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The tumor interferes with the lungs and affects breathing mechanisms. So the patient has shortness of breath.
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The mediastinal disease causes chest pain as it involves the organs present in the chest.
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If the tumor affects the upper part of the respiratory tract, it leads to hoarseness of voice. Severe conditions cause noisy breathing.
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The immune system becomes weak, and the patient is affected by fever and weight loss.
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The lymph nodes become swollen and painful in case of lymphadenopathy.
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The patient experiences sweating and chills during the night.
How Is Mediastinal Disease Diagnosed?
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Needle Biopsy - The presence of abnormal cells can be detected with the help of a needle biopsy. The cells are collected from the cavity using the needle insertion technique. It is performed with the help of computed tomography. It also provides the images in cross-section, so the presence of tumors in the chest can be identified. This is used as a diagnostic tool to observe suspicious growth in the organs.
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Chest X-Rays - It is a non-invasive diagnostic procedure used to investigate the tumor in the chest. The radiographic image shows light gray shades indicating the presence of tumors in the lungs, air passages, and heart.
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Bronchoscopy - The flexible tube is inserted into the air passages to collect the neoplasm present in the bronchi or lungs. The abnormal tissue is collected and sent to the laboratory for biopsy. The microscopic examination reveals the proliferation of cancer cells in the tissue.
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Magnetic Resonance Imaging (MRI) - It is a painless test used to produce images of the organs present in the chest. Magnetic resonance imaging uses radio waves to get accurate details about the enlargement of the lymph nodes, abnormal growth in the nervous tissue, and the aortic aneurysm. The tumor spread to other organs with magnetic resonance imaging.
What Are the Various Treatment Methods for Mediastinal Diseases?
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Thoracoscopy - The tumor present in the chest is surgically removed by thoracoscopy. It is done with the help of a camera. The surgeon performs the video-assisted thoracoscopy and removes the unwanted tissue along with adjacent linings to prevent proliferation. This surgery has a high recovery rate. Neurogenic tumors, thymoma, and lymphoma are removed by thoracoscopy.
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Radiation Therapy - Radiation therapy is given to reduce the size of the neoplastic tissue. Some patients require chemotherapy with anticancer drugs along with radiation. Since it is a non-invasive technique, it prevents damage to nearby tissue. Chemotherapy and radiation therapy are also given before the surgery to minimize the tumor size.
Conclusion:
The medical professional decides the treatment method depending on the age and type of tissue involved. The tumor involving the cardiac tissues is life-threatening and must be operated on as early as possible. If the symptoms of respiratory illness get worse for more than two weeks, then consult the medical professional immediately. The patient affected by the tumor due to mediastinal disease must have a regular follow-up to prevent the recurrence of the tumor. The prognosis of the benign tumor is more than the malignant tumor.
