Mediastinal lymphadenopathy is the swelling of the lymph nodes in the chest cavity. It is a symptom of various conditions and can be benign or malignant.

Mediastinal lymphadenopathy is a condition where the lymph nodes in the mediastinum, the central part of the chest cavity between the lungs, become enlarged.

Several conditions can cause lymph node enlargement in this area.

This article looks at the symptoms of mediastinal lymphadenopathy, its causes, treatment, diagnosis, and more.

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Mediastinal lymphadenopathy involves abnormal enlargement of one or more lymph nodes in the mediastinum.

The mediastinum consists of several structures, including the trachea, esophagus, heart, and large blood vessels.

The mediastinal lymph nodes are located in this region and can become enlarged for several reasons, including:

  • lower respiratory tract infection
  • an inflammatory or autoimmune condition
  • cancer

People with mediastinal lymphadenopathy typically experience the following:

A person may develop mediastinal lymphadenopathy for one of several reasons.

Malignancy

Malignant causes such as lymphoma or lung cancer make up most mediastinal lymphadenopathy cases.

Lymphoma is a form of cancer that begins in the lymphocytes, a type of white blood cell.

Swelling in the lymph nodes around the lungs or in the chest often signals that a person has lung cancer or that cancer has spread to the chest from another part of the body.

Benign causes

Benign causes are those that are not cancerous. Most conditions that cause inflammation in the chest area can cause enlargement of the chest lymph nodes.

Swollen lymph nodes may be a sign of a problem with the immune system. Lymph nodes are small, bean-shaped structures that are part of the lymphatic system. These nodes help fight infections by filtering out bacteria and viruses from the bloodstream and transporting them throughout the body.

Lymph nodes can swell or enlarge as they work to filter out the “bad” cells. Swollen lymph nodes, or lymphadenopathy, can occur when the immune system fights an infection.

Noncancerous causes of mediastinal lymphadenopathy include:

Swollen lymph nodes are one of the main signs of lymphoma, as the lymph nodes become cancerous. It can signify that a person has cancer somewhere in the chest or that cancer has spread from other areas of the body to the lymph nodes in the chest.

Mediastinal lymphadenopathy is a symptom of other conditions rather than a condition itself.

There is no way to treat mediastinal lymphadenopathy directly. Instead, doctors focus on treating the underlying cause, such as:

  • Cancer: The treatment for cancer varies depending on the type of cancer, where it started, and how far it has spread throughout the body. The most common treatments include surgery, radiation therapy, chemotherapy, immunotherapy, or a combination.
  • Infection: Depending on the type of infection, doctors may use antibiotics, antifungals, or supportive treatment to resolve the issue.
  • Medications: Some medications can cause the lymph nodes to swell. A doctor may recommend switching medications if a person is experiencing swelling due to taking them.

In most cases, people cannot feel or see mediastinal lymphadenopathy since the chest lymph nodes are located deep inside the body.

Doctors need to use diagnostic testing to diagnose mediastinal lymphadenopathy.

Imaging tests

Chest X-ray is the most common diagnostic test for mediastinal lymphadenopathy.

CT scans are more sensitive than chest X-rays and can detect abnormalities not seen on an X-ray, but they take longer and may require a contrast dye injection. Unlike CT scans, MRIs do not involve radiation but are more expensive.

Mediastinoscopy

A mediastinoscopy is a surgical procedure in which a surgeon examines the mediastinum, the space in the chest between the lungs. The mediastinum contains several vital structures, including part of the heart and its major blood vessels, as well as lymph nodes and other tissues.

To check the lymph nodes in the chest, a surgeon makes a small cut near the breastbone and inserts a scope. If the surgeon notices any abnormal areas, they will remove and biopsy them.

Mediastinal lymphadenopathy itself does not cause complications. However, complications may arise due to the underlying condition. For example, cancer can metastasize throughout the body.

The outlook for someone with mediastinal lymphadenopathy depends on the underlying cause.

For example, the overall 5-year relative survival rate for people with non-Hodgkin lymphoma (NHL) is 73%.

Accurately diagnosing the underlying condition is important for achieving favorable outcomes for patients.

Mediastinal lymphadenopathy is a condition in which the lymph nodes in the chest are enlarged. It occurs in people with Hodgkin disease or other cancers. Infections, such as upper respiratory infections, may also cause this type of lymph node swelling.

Doctors diagnose mediastinal lymphadenopathy by taking a medical history, performing a physical examination, and using diagnostic imaging tests such as X-rays or CT scans.