Correct!
1. Cervical mediastinoscopy
The lesion could be approached through bronchoscopy with transbronchial biopsy, although cervical mediastinoscopy is probably the single best procedure for obtaining material sufficient for diagnosis. Open surgical biopsy certainly could also obtain the tissue required for diagnosis, but is needlessly invasive. The lesion is not readily accessible to transthoracic fine needle aspiration biopsy. A left anterior mediastinotomy procedure (Chamberlain procedure) provides access to the left mediastinum and subaortic region, but would not be appropriate for obtaining tissue from this lesion. Serial imaging to assess for change plays not role in the management for this patient, given the size of the lesion and the fact that it is potentially new or has shown growth over the previous year.
Cervical mediastinoscopy was performed. What is the most likely diagnosis? (Click on the correct answer to move to next panel)