with biopsy is a minor surgical procedure that gathers samples
of lymph nodes. Lymph nodes
are clusters of cells that play a key role in fighting off viruses and bacteria
in your body. A surgeon takes the tissue sample from your chest.
A surgeon inserts a small instrument with a light—called a mediastinoscope—through an incision in
your throat. They run it under your sternum (breastplate) and move it into the area between your
lungs. You’ll be under general anesthetic during the biopsy.
The test looks for any abnormalities and takes one or more small
tissue samples, called biopsies.
Lab technicians examine and assess the biopsies in a lab. This test commonly
checks for cancer.
Your doctor might order a mediastinoscopy with biopsy for several
reasons. They may want to:
- see if a cancer in the lung has spread to the lymph
- check for other lymphatic cancers, including
Hodgkin’s disease or lymphoma
- identify infections, such as tuberculosis
Doctors often use mediastinoscopy to understand how far lung or
other cancers have advanced. This is also known as staging the cancer, or
determining what stage your cancer has reached. This information can help you
and your doctor select the most appropriate course of treatment.
Doctors base the stage of
any type of cancer on several factors. These include:
- the size of the primary tumor
- whether the cancer is present in distant parts
of the body
- whether the lymph nodes are involved
A surgical team will perform your mediastinoscopy in a hospital
or outpatient surgical center.
You shouldn’t eat or drink anything after midnight on the day
before your test if you are advised not to. Make sure to arrive at the surgery
site at the scheduled time.
After you check in, you will be taken to a private room or
cubicle, where you will be asked to remove your clothing and jewelry and put on
a hospital gown (it may be a good idea to leave jewelry at home to prevent
loss). The nurse will then start an IV in your hand, wrist, or arm. You may
feel a short, sharp pain when the nurse inserts the needle, but the discomfort
will fade quickly. The nurse will tape the IV in place so that you don’t
accidentally remove it.
When it’s time for your procedure, a nurse or technician will
take you into the operating room on a cot with wheels, called a gurney.
Once you’re in the operating room, you will lie on your back on
the operating table. An anesthesiologist will then inject a medication into
your IV that will put you into a deep sleep. You won’t feel pain during the
procedure. Once you’re unconscious, the doctor will place a flexible tube into
your mouth and maneuver it into your lungs to help you breathe.
The surgeon will then make an incision at the base of your throat
and thread the mediastinoscope into the space between your lungs.
They’ll examine the area visually. The surgeon will also remove a
small piece of tissue from the lymph nodes and from any other area that looks
inflamed, infected, or otherwise abnormal.
When this process is complete, the surgeon will withdraw the
mediastinoscope, remove the breathing tube from your lungs, and stitch the incision closed. The tissue
samples will go to the laboratory for analysis.
You will wake up in the recovery room. The staff there will offer
you pain medications and monitor your vital signs to make sure they remain
stable. If you don’t suffer any complications, you can go home within a few
Your throat will probably feel swollen and tender for a few days,
and it may hurt to talk or swallow. Talk to your doctor about the best
medications to manage any pain.
Any time you receive general anesthesia, you run a slight risk of
an allergic reaction to the medication. This can lead to difficulty in
The most serious risk during this surgery is the accidental
puncture of blood vessels, which could lead to a hemorrhage which can be fatal.
This complication, however, is exceedingly rare.
When doctors look at the biopsies, they will study the size and
shape of the cells in your tissue. This will determine whether they are normal
(benign) or malignant (cancerous). This type of molecular cell study is
If the problem is an infection, they will culture the tissue to
identify the microorganisms present and select the best medications to treat