Overview

It is a central space in the chest where it contains organs, loose connective tissue, etc except the lungs and pleura. It has superior and inferior divisions, inferior division is further divided into the anterior, middle and posterior mediastinum.

• Most of them are diagnosed incidentally for unrelated mediastinal pathology
• Symptoms are due to pressure effects or systemic illness

Pressure effects – cough, stridor, hemoptysis, shortness of breath, pain, dysphagia, hoarseness, facial and/or upper extremity swelling due to vascular compression, hypotension due to tamponade physiology or cardiac compression, and Horner syndrome due to sympathetic chain involvement.

Systemic effects – Fever, night sweats, and weight loss can be present in the case of lymphoma or may be due to a variety of paraneoplastic syndromes, such as myasthenia gravis with thymoma.

Tumor markers are the substances produced by the cancerous cell which are released into the bloodstream

• Anti-acetylcholine receptor antibodies – may be positive in some patients with thymictumors and indicate or herald the presence of myasthenia gravis.
• Alpha-fetoprotein (AFP) – Elevated levels are found in malignant germ cell tumors.
• Beta-human chorionic gonadotropin (beta-hCG) – is increased in germ cell tumors.
• Lactate dehydrogenase (LDH) – may be elevated in germ cell tumours and lymphoma.