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- Imaging
- Biopsy
- EBUS- Endobronchial ultrasound is an outpatient procedure where a small tube is entered into the nostrils and reached into the windpipe to assess the adjacent structures around it. It is a non-invasive procedure where a tissue diagnosis can be obtained from the lymph nodes, which helps in diagnosing mediastinal pathology.
- Endo-ultrasound (EUS), in rare occasions where an endoscope is placed in the oral cavity and para-esophageal tissues like lymph nodes, etc., can be visualized and biopsied.
- CT scan - It is a diagnostic imaging procedure that uses x-rays to build cross-sectional images of mediastinal tumors.
- Contrast-enhanced CT chest can confirm the presence of a mediastinal mass, and also provides detailed information regarding the mediastinal abnormality, including its location, size, relationship to other structures, and tissue characteristics, particularly involvement/invasion or compression of surrounding structures, which is critical in planning treatment.
- Positron emission tomography (PET) scan - Positron emission tomography (PET) scan does functional and morphological detail scanning by utilizing radiation derived from isotope labeled glucose molecules that enable detection of cellular glucose uptake in cancer.
- MRI - Magnetic resonance imaging (MRI) uses the interaction of radio waves and magnetic field, which will be processed in a high-speed computer system to produce detailed scan pictures of the tissue, organs, bones, ligament, and cartilage.
- Bone scan: A bone scan uses a radioactive tracer to look at the inside of the bones.
- CT Guided/ Ultrasound guided biopsy- It is done in case of suspicious lymphoma and in borderline operable tumors where neoadjuvant treatment is planned.
- Surgical biopsy - When a percutaneous or endobronchial biopsy is not possible or cannot provide adequate tissue to definitively establish a diagnosis, a surgical biopsy may be necessary.
- Anterior mediastinotomy for lesions that are substernal (behind the sternum).
- A cervical mediastinoscopy is an option for lesions in the middle mediastinum. A mediastinoscope is inserted through a small incision just above the sternal notch and directed into the mediastinum. This approach is effective at obtaining tissue from mediastinal masses that are adjacent to the airway.
- Chemotherapy- This depends on the histopathology of the mediastinal tumor.
- Targeted Drug therapy- This depends on the histopathology of the mediastinal tumor.
- Immunotherapy- This depends on the histopathology of the mediastinal tumor.