The professional anatomical term "mediastinum" is unfamiliar to many people, and "mediastinal tumor" is unheard of. Where is it in the human body? Is this tumor serious? What should I do if I find a mediastinal tumor? Let's unveil the mystery of mediastinal tumors layer by layer.
First, the mediastinum is a structure within the chest cavity of the human body. The largest organ in the chest cavity is the lung, one on the left and one on the left, and this part of the structure in the left and right lungs is called the mediastinum. "Vertical", vertical row, "interval", separation, as the name suggests. The mediastinal region contains many shaped organs, such as the heart, large blood vessels, trachea, esophagus, etc., and also distributes some invisible tissue cells, such as thymic tissue, lymphoid tissue, neural tissue, primitive ectoderm cells and so on. Mediastinal tumors are mainly derived from these tissue cells in the back.
How is the tumor in the mediastinum discovered? One is a physical examination, and the other is that the patient has uncomfortable symptoms to take the initiative to check. It seems that it is not good to see a diagnosis such as "mediastinal placeholder" or "mediastinal tumor" on the medical examination report. At this time, it is necessary to calm down and carefully analyze. First of all, to see the size of the lesion, if it is less than 1.5cm, and do not need to take any measures immediately, we recommend continuing to observe, after an interval of 3-6 months to recheck the CT, because the small nodules may be the inflammatory response of the lymph nodes, and they will subside after a long time. Even if the size of the mass is more than 2 cm, it should be treated differently, because in the mediastinal mass, some of the conditions are benign lesions, such as mediastinal cysts, thymus hyperplasia, etc., which may gradually shrink over time, and it is not cost-effective to take a big risk to perform a major surgery at this time. Of course, in rare cases, such as as gradually enlarging cysts, or thymus hyperplasia with myasthenia gravis, surgical removal is also required. At present, CT tests are not very effective in distinguishing cysts, hyperplasia and solid tumors, while the accuracy of MRI is much higher. Surgery is recommended if the examination determines that it is a solid mass and the boundaries are clear.
If you go to check CT because of chest tightness, chest pain, and face swelling, and find a mediastinal tumor, then you should be careful, often because the tumor is relatively large, compressing the trachea, blood vessels and thus producing symptoms. It is imperative to confirm the diagnosis by puncture biopsy as soon as possible, because different tumor treatment options are completely different, and only the diagnosis can be confirmed first. In recent years, the confirmed diagnosis rate of biopsy under the guidance of B ultrasound has reached more than 95%.
If lymphoma is diagnosed, treatment is mainly chemotherapy and does not require surgery. In recent years, we have taken the lead in carrying out radiotherapy induction combined surgery for different stages of thymic tumors, as well as new models such as full chest radiotherapy and hot perfusion chemotherapy after surgical resection, which have greatly improved the treatment effect. For other germ cell tumors and neurogenic tumors, it is necessary for a joint team of surgeons, radiotherapy, and chemotherapy doctors to formulate the most suitable plan according to different stages.
In short, do not panic when you find a mediastinal tumor, follow the steps of science, carefully identify, kill good people, do not let go of bad people, deal with bad people skillfully use eighteen weapons, and eliminate evil.
■ Wang Changlu, Deputy Chief Physician of the Department of Radiotherapy, Shanghai Chest Hospital, Master of Medicine.
Expertise: Radiation therapy for lung cancer, esophageal cancer, mediastinal tumors, especially in the differential diagnosis of difficult mediastinal tumors, multidisciplinary treatment of invasive thymomas, and the treatment of recurrent and metastatic thymomas.
Specialist Clinic: Friday morning