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September 1955

Exploratory Thoracotomy in Chronic Lymphadenitis of the Mediastinum

AMA Arch Surg. 1955;71(3):383-394. doi:10.1001/archsurg.1955.01270150077009

Chronic inflammatory processes of the mediastinal lymph nodes may produce constrictive, obstructive, or perforative lesions of the tracheobronchial tree, the esophagus, and the blood vessels of the mediastinum. Over a period of six years 33 such patients have come under our observation with involvement of one or more lymph nodes. Some were asymptomatic and were referred because of a mediastinal mass found on routine x-ray examination. Others presented severe symptoms, including hemoptysis, superior vena cava occlusion, and dysphagia, which, on occasion, could not be differentiated from those produced by malignant disease except by surgical intervention.

The anatomy of the mediastinal lymph nodes and their drainage patterns have been demonstrated by previous investigators.* These lymph nodes have been classified into groups according to their anatomical relations within the mediastinum. From a surgical standpoint these have been classified into three main groups: paratracheal, parabronchial, and paraesophageal. The paratracheal and paraesophageal lymph nodes

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