What is Mediastinal Lymph Node Evaluation?
Enlarged lymph nodes in the mediastinum can be caused by infection (such as TB), inflammatory conditions (such as sarcoidosis) or cancer. Evaluation combines CT/PET-CT imaging with tissue sampling, most commonly by EBUS-TBNA, to arrive at an accurate diagnosis.
Why it is done
- Enlarged mediastinal nodes on CT
- Suspected TB lymphadenitis or sarcoidosis
- Suspected lymphoma or metastatic cancer
Before the procedure
- Fasting for about 6 hours before the procedure (you will be given exact instructions)
- Inform the team about blood thinners, diabetes medicines and allergies — some medicines may need to be paused
- Blood tests and recent imaging (CT scan) are usually reviewed beforehand
- Bring a family member or friend to accompany you home
During the procedure
- Imaging is reviewed to plan which nodes to sample
- EBUS-TBNA is performed to sample the selected nodes
- Samples are sent for pathology, microbiology and other tests as needed
After the procedure
- You will be observed for a short period until the sedation wears off
- Avoid eating or drinking for about 1–2 hours, until the throat numbness settles
- A mild sore throat, cough or slight blood-streaked sputum may occur briefly
- Do not drive or operate machinery for the rest of the day after sedation
- Biopsy results usually take a few days; your follow-up will be scheduled
Safety & risks
Bronchoscopy is generally a safe procedure. Possible risks include sore throat, transient fever, minor bleeding, low oxygen levels during the procedure and, rarely, pneumothorax (especially after lung biopsy). Your doctor will discuss the risks relevant to you before obtaining consent.
Preparation instructions may differ for individual patients — please follow the specific advice given at your consultation.