Mediastinal disease

Written by: Dr. Laureano Molins López-Rodó
Edited by: Top Doctors®

The mediastinum is an extrapleural space located in the middle of the lungs that often affected by different pathologies. Many specialists in Thoracic Surgery pathological studies have been conducted, surgical and physiological level about these diseases, making a lot of progress in the fight against cancer of the mediastinum.


Anatomy of the mediastinum

In his complexion, mediastinum includes the heart, large blood vessels, thymus, esophagus, trachea and connective tissues. For the study of pathologies, mediastinum is usually divided into three parts:

  • Anterior mediastinum or prevascular: located between the back of the sternum and the anterior surface of the pericardium.
  • Middle mediastinum or visceral: situated between the old anterior pericardium and the edge of the vertebral body.
  • Paravertebral posterior mediastinum or groove: located between the front edge of the vertebral body and the anterior surface of the ribs on his paravertebral portion.

The most frequent diseases of the mediastinum are of two types: infections (mediastinitis) and mediastinal tumors.



Acute mediastinitis

Acute mediastinitis is a bacterial infection of the connective tissue that involves mediastinal structures. It is a rare but very dangerous disease, if not treated quickly, it can become deadly.

Causes: Trauma, surgical complications, infections of the tissues, esophageal rupture, necrosis of cancer of the esophagus.

Symptoms: Fever, sore back and neck, sepsis, tachypnea, emphysema.

Treatment: Surgical drainage, hemodynamic support, tracheotomy and antibiotics, depending on the case.

Chronic mediastinitis

Chronic mediastinitis is rare and, in most cases, chronic granulomatous inflammation (tuberculosis, histoplasmosis) should. Mostly involves the anterior mediastinum and often there are no symptoms.


Mediastinal tumors

Because of the similarity between the different mediastinal tumors they are considered under this category both tumors inflammatory origin or derived from a malformation as malignancies and thyroid or parathyroid. Very often, these cancers are in 90% of benign cases and no symptoms: with diagnostic imaging tests are discovered.

In contrast, tumors with symptoms have a 50% chance of being malignant. Treatment varies depending on the severity of the cancer in question: surgical excision, biopsy, radiotherapy and / or chemotherapy.

Discover the exact location of the tumor in the mediastinum allows specialists often able to distinguish and establish an etymology.

Anterior mediastinum

  • Thymic tumors (benign and malignant thymoma, thymic carcinoma, carcinoid, germ cell tumors, seminomas primitive, thymolipoma, endotorácico goiter)
  • Thyroid and parathyroid tumors

Middle mediastinum

  • Pericardial cysts
  • Bronchogenic cysts
  • Enteric cysts
  • Lymphadenopathy (benign and metastatic)
  • Lymphomas
  • Other posterior mediastinum
  • Neurogenic tumors
*Translated with Google translator. We apologize for any imperfection

By Dr. Laureano Molins López-Rodó
Thoracic & Cardiac Surgery

Dr. Molins López-Rodo is one of the foremost experts on lung cancer and minimally invasive surgery, currently operates in the most prestigious centers of Barcelona and Head of Thoracic Surgery of Hospital Clínic and Sagrat Cor de Barcelona. He specialized in prestigious universities and centers like the Mayo Clinic and Harvard Medical School in the United States.

*Translated with Google translator. We apologize for any imperfection

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