Lymphadenopathy of the mediastinum and lungs
Mediastinal lymphadenopathy is enlargement of lymph nodes located in the mediastinum. This pathology is not a separate disease but a symptom indicating that the patient develops either malignant or infectious or systemic inflammatory process.
The mediastinum: what is it?
Mediastinum or mediastinal space is the space inside the chest limited by the sides of the pleural cavities, at the front, the sternum, and at the rear by the spine. The organs located in this space, called the mediastinum. These include:
- The trachea.
- The roots of the lungs.
- The heart and pericardium.
- The esophagus.
- Lymph nodes.
- Intrathoracic arterial, venous and lymphatic vessels.
- Nervous education.
In the mediastinal space hosting multiple groups of lymph nodes – paratracheal, bronchial, lung roots, deep cervical, aortic, paraesophageal, chest, etc. Using these nodes the lymph is collected not only from the thorax, but also from the anatomic structures of the abdominal cavity, retroperitoneal space and even of the pelvis, so any malignant or inflammatory processes in the body can affect the state of the mediastinal lymph formations.
What is lymphadenopathy?
This term refers to enlarged lymph nodes. The increase may be caused by infectious diseases (lymphoid tissue, as an organ of the immune system, reacts thus penetrated into the body infection), cancer, diseases of the lymphatic system and malignant processes at other sites (tumors metastasize to the lymph nodes), systemic illnesses, as well as taking a number of drugs (Allopurinol, some antibiotics and sulfonamides, gold preparations, etc.).
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If we talk about mediastinal lymphadenopathy, most often, this symptom appears in the following diseases:
- When lymphoma is a malignant disease of lymphatic tissue. With active lymphoma affects not only the lymphatic education of the mediastinum, and lymph nodes at other sites, and internal organs with lymphatic tissue. In addition, malignant lymphomas with high activity are able to grow into surrounding structures. For example, in lymphomas of mediastinal lymph nodes at risk are the lungs, trachea, esophagus, vessels, pleura, etc.
- Metastases of carcinoma – cancer originating from epithelial tissue. Mediastinal lymph nodes are most often affected in cancer of the lung, rarely in tumors of the breast, gastrointestinal tract, thyroid gland and larynx.
- When nonneoplastic diseases – tuberculosis, sarcoidosis of the lungs, etc. When sarcoidosis swollen lymph nodes due to the formation of specific granulomas, and tuberculosis primary tuberculous lesions of the body.
Lymphadenopathy of the mediastinum in lung of bronchial cancer has a predominantly unilateral localization, sarcoidosis, as a rule, is accompanied by swollen lymph nodes of the pulmonary roots on both sides. When metastasis of tumors located outside the thoracic cavity, also seen with their pattern of lesion mediastinal lymph formations, due to features of lymph drainage. So, breast cancer «loves» retrosternal lymph nodes, thyroid cancer lymph nodes of the upper mediastinum, cancer of the digestive system – the group of mediastinal lymph formations located closer to the spine, etc.
What is mediastinal lymphadenopathy?
In the initial stages of development of pathological process, when the lymph nodes have not increased, lymphadenopathy can occur completely unnoticed. If the lymphatic education are beginning to squeeze other anatomical structures of the mediastinum, the following symptoms appear:
- The pain in his chest.
- Hoarseness (due to compression of the larynx nerves).
- Cough and shortness of breath (pressure on the trachea and bronchi leads to reflex cough and shortness of breath).
- Dysphagia caused by compression of the esophagus.
- Swelling of the face, neck, shoulder (due to the compression of the veins).
These signs do not necessarily indicate that the patient have lymphadenopathy, there are other possible causes. Therefore, such patients require a comprehensive examination, including x-rays, a CT scan of the chest, ultrasound of internal organs, blood tests and other studies. When the detection of enlarged mediastinal lymph nodes it is desirable to conduct a biopsy, which gives accurate information about the nature of the findings: what is cancer, sarcoidosis, infectious-inflammatory process, or something else.