Def. of Mediastinal disease:
Group of clinical manifestation resulting from mediastinal compression & less commonly from pathological fibrosis within the mediastinum.
Causes:
LN++
Superior mediastinun
Thymic tumour
Retrostemal goitre
Aortic aneurysm
Inferior mediastinum
Ant. M Dermoid cyst
Middle M. Pleural. effusion
Huge cardiomegally.
L.N.
Aortic Aneurysm.
Post. M Hiatus hernia
Neurofibroma
Aortic aneurysm
C/P
According to the site of the tumor or mass & which part is affected
3 Tubes
Trachea Dyspnea
Brassy cough
Oesophagus Dysphagia
Thoracic duct Chylous effusion.
3 Vessels
S. V.C. Oedema of the face
Collaterals on the chest.
Bilateral congested non
pulsating neck veins.
Azygos vein.
Aorta Ischemic pain
Inequality of pulse of upper Limbs.
3 Nerves
Left Recurrent Laryngeal nerve Hoarseness of voice
Sympathetic chain Horner s syndrome.
Phrenic nerve diaphragmatic paralysis

3 Bones
Ribs pain
Vertebra pain
Sternum pain
Investigation
1-
Plain x-ray Benign mass large, rounded with well
defined border
Malignant
ill defined border
2- Fluoroscopy to diagnose

Pulsating mass pleural effusion diaphragmatic movement
3- Left lateral view + Barium swallow

Left A ++ Ant. M. mass Post .M. mass
4- Bronchoscopy & biopsy if needed.
5- Mediastinoscopy.
6- Scalene node biopsy.
7- Radioactive I uptake.
8- Surgical exploration.
Treatment:
Treatment of the cause

Source: Internal Medicine Book of Dr.Osama Mahmoud (Ain Shams University)