Center for Thoracic Oncology
Diseases & Conditions
Mediastinal Tumor - Diagnostic Procedures
How are Mediastinal Tumors Diagnosed?
Your multidisciplinary medical team, including thoracic surgeons, at Boston Medical Center’s Center for Thoracic Oncology will work with you and your primary care physician to diagnose your tumor.
Tests your doctor might recommend include:
- Blood Test
- Computed Tomography (CT) scan
- Magnetic Resonance Imaging (MRI)
- Needle Biopsy
- Position Emission Tomography (PET) scan
- Pulmonary Function Test
- Stress Test
A common tool for disease screening, blood tests provide information about many substances in the body, such as blood cells, hormones, minerals and proteins.
CT scans use x-rays to create 2-dimensional images of your body, including your lymph nodes. If contrast dye is used to improve the computer image, you may need to avoid eating or drinking for 4 to 6 hours before the test. Be sure to tell your provider prior to the test if you have any allergies or if you have kidney problems.
This test uses a magnetic field, radiofrequency pulses, and a computer to produce detailed images of body structures in multiple places. You may be asked to drink a contrast solution for better imaging, and you will most likely lie on a moving table as pictures are taken. MRI is a more detailed tool than x-ray and ultrasound and for certain organs or areas of the body, it provides better images than CT. MRI may not be recommended if you have a pacemaker or other metal implant.
Your physician makes an incision into or through the middle of the chest bone (sternum) to gain access to the lungs for diagnostic purposes. You should refrain from eating or drinking after midnight prior to surgery, and arrange for a ride home, as you will be given sedatives.
When performing mediastinoscropy, your physician inserts a lighted instrument (mediastinoscope) through a small incision in the neck. He or she is then able to see into the chest cavity where the lymph nodes surround your windpipe and trachea and take a tissue sample if necessary. You should refrain from eating or drinking after midnight prior to surgery, and arrange for a ride home, as you will be given sedatives.
Your physician will apply an anesthetic (numbing agent) and will insert a needle between the ribs and into the chest, guided by CT scan or x-ray. A sample of tissue is obtained and then examined under a microscope in a laboratory.
A PET scan is used to detect cellular reactions to sugar. Abnormal cells tend to react and "light up" on the scan, thus helping physicians diagnose a variety of conditions. For the PET scan, a harmless chemical, called a radiotracer, is injected into your blood stream. Once it has had time to move through your body, you will lie on a table while a scanner follows the radiotracer and sends 3-D images to a computer screen. Patients are generally asked to wear comfortable clothing and refrain from eating for 4 hours before the scan. Tell your doctor if you are pregnant or breastfeeding. Patients with diabetes should discuss diet guidelines with their physician for the hours leading up to the scan.
A pulmonary function test is used to understand how well your lungs are working. With each breath you take in and breathe out, information is captured about how much air your lungs take in, how the air moves through your lungs, and the how well your lungs deliver oxygen to your bloodstream.
A stress test will provide information about how your heart functions during exercise. Your physician will monitor your heartbeat and blood flow as you walk on a treadmill and will image your heart using a radioactive tracer. This will be used to diagnose any problems as well as plan treatment.