What is the thoracic mediastinum?

When hearing the word "mediastinum", some people may ask, is the mediastinum related to what we usually call "hiccups"? For this question, it cannot be said that there is no connection. What we call hiccups in daily life is a normal physiological phenomenon, which is mainly caused by the spasm and contraction of the diaphragm.

The mediastinum we are talking about today is a medical term, which is the general term for the organs, structures and connective tissues between the left and right mediastinal pleura. This may be a bit obscure and difficult to understand. To put it simply, the mediastinum exists in the space behind the sternum and in front of the spine. The reason why it is called the mediastinum is mainly because it exists longitudinally in the body. Generally, we are accustomed to dividing it into two parts, upper and lower. Its main dividing line is the sternal angle and the plane of the lower edge of the fourth thoracic vertebra. Under normal circumstances, the position of the mediastinum is relatively fixed. When pneumothorax occurs, the mediastinum will be displaced to the opposite side due to the influence of internal forces.

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As the saying goes, "there are all kinds of birds in a big forest", in fact, the human body is also the same. The more organs there are, the more problems there will be. In our daily life, because the mediastinum is surrounded by very important organs, such as the esophagus and trachea and various nerves, this directly leads to the fact that once there is a problem in this place, there is a high probability of affecting the circulatory system, respiratory system or digestive system. However, it is undeniable that the incidence of mediastinal tumors in children is lower than that in adults, but there is a greater chance of cancer. About two-thirds of sick children have symptoms such as cough, low fever, and difficulty breathing in the early stage, which is related to the small chest capacity of children. When some sick children undergo chest CT examinations, if they have malignant tumors, anemia and weight loss are occasionally found. If the above symptoms are found, you should seek medical attention as soon as possible. Doctors can determine the location and size of the tumor through chest CT, and know the nature of the tumor through ultrasound examination. Only in this way can we better help children and eliminate the disease in the bud.

1.What problems are likely to occur in the mediastinum?

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As for the mediastinum, it is the most prone to cancer in daily life because of its unique existence. The most common one is the mediastinal tumor. Some TV dramas have shown mediastinal tumors, so they are not new. For professionals, there are many types of mediastinal tumors, such as thymic epithelial tumors. Thymoma is the most common and important anterior mediastinal tumor, which is more common in middle-aged people.

Not all diseases will show symptoms, just like mediastinal tumors. Many patients will not feel any discomfort in the early stage. So how are they discovered? This is due to physical examinations. Some of them are discovered accidentally. Before the discovery, the patient simply went to the hospital to see a minor problem. As a result, in front of various examination instruments, the mediastinal tumor had nowhere to hide and was exposed. But simply emphasizing what are the symptoms of mediastinal tumors at a certain moment? It can only be said that chest pain, chest tightness, cough and shortness of breath are the most common early symptoms. However, this symptom is not specific, so it is easy to misdiagnose and miss. However, as the disease continues to develop, larger tumors compress or invade important organs in the mediastinum, which can cause circulatory, respiratory and nervous system dysfunction. For example, if the trachea is compressed, shortness of breath and dry cough will occur. Squeezing the esophagus can cause difficulty in swallowing. Some patients with thymoma are accompanied by muscle weakness, pure red blood cell aplasia, connective tissue diseases, etc.

2. What to do after discovering a mediastinal tumor

When patients experience unexplained chest pain, chest tightness, cough, shortness of breath and other symptoms, it is recommended to go to the hospital's thoracic surgery department for relevant examinations to make a clear diagnosis. Most mediastinal tumors and cysts are easily missed by chest X-rays. Chest CT scans are more accurate, have higher resolution, and are more conducive to diagnosis. Therefore, routine chest CT examinations are recommended. Once a mediastinal tumor or cyst is diagnosed, most of them require surgical treatment, except for malignant tumors such as lymphoma that are suitable for chemotherapy and radiotherapy. Surgical resection is also recommended for symptomatic benign mediastinal tumors and cysts. After discovering a mediastinal tumor, it is recommended to go to a regular hospital for treatment in time. Some mediastinal tumors are difficult to diagnose as benign or malignant before surgery. If surgery is not performed in time, treatment may be delayed.

3. What to do if thymoma is highly suspected during the examination

Patients with a high suspicion of thymoma should be treated by a multidisciplinary team experienced in the diagnosis and treatment of thymoma. Surgical treatment of thymoma patients is carefully evaluated by professional thoracic surgeons for the resectability of the tumor. Based on a comprehensive evaluation of clinical features and imaging examinations, surgical resection should be the first choice, avoiding puncture biopsy. Experienced thoracic surgeons can choose puncture biopsy or open biopsy as the first choice for patients with thymoma that cannot be completely removed, and try to avoid induction therapy after a clear pathological diagnosis through the pleural route. After drug or radiotherapy, professional thoracic surgeons can evaluate the possibility of surgical treatment. Do patients with thymoma need adjuvant therapy after surgery? Adjuvant therapy after thymectomy should be decided by an experienced multidisciplinary team for mediastinal tumors. For patients with stage 2 thymoma without capsular invasion after complete resection, postoperative adjuvant therapy is not recommended, and postoperative recurrence can be routinely monitored. Patients with stage 3 thymoma with capsular invasion after complete resection should receive postoperative radiotherapy. Patients with thymoma after R1 resection should receive postoperative radiotherapy. Patients with thymoma who undergo R2 resection should receive radical radiotherapy and chemotherapy.

Conclusion

The location of the mediastinum is somewhat unfamiliar to many people, and few people know that there is such a "secret place" in our chest cavity. Mediastinal tumors refer to tumors that originate from or extend into the mediastinum. The actual number of patients with this disease is not low, but people do not pay enough attention to it. Tumors in this location are like silent "time bombs" that threaten the patient's life at any time. Therefore, both patients and medical staff should be highly vigilant about this situation to avoid more serious situations.