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Recent Advances in Chest Medicine |

Diagnosing and Staging Lung Cancer Involving the MediastinumMediastinal Staging

Septimiu Dan Murgu, MD, FCCP
Author and Funding Information

From the Department of Medicine, The University of Chicago, Chicago, IL.

CORRESPONDENCE TO: Septimiu Dan Murgu, MD, FCCP, Department of Medicine, The University of Chicago, 5841 S Maryland Ave, MC 6076, Chicago, IL 60637; e-mail: smurgu@medicine.bsd.uchicago.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(5):1401-1412. doi:10.1378/chest.14-1355
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The purpose of this article is to provide an update on evidence-based methods for mediastinal staging in patients with lung cancer. This is a review of the recently published studies and a summary of relevant guidelines addressing the role of CT scan, PET scan, endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA), and mediastinoscopy as pertinent to lung cancer staging and restaging. The focus is on how these diagnostic methods fit into the best algorithm for patients with chest imaging abnormalities suspected of malignant disease. Several studies, meta-analyses, and systematic reviews specifically targeted the role of PET scan, EBUS-TBNA, and mediastinoscopy for detecting mediastinal lymph node involvement in patients suffering from lung cancer. Based on the recommendations from the currently published guidelines, algorithms of care are proposed for staging and restaging of the mediastinum.

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