Overview

Mediastinal lymph node FNAC/FNAB is a minimally invasive procedure used to diagnose and stage diseases involving lymph nodes in the chest, particularly lung cancer. The mediastinum is the central area of the chest between the lungs, containing vital structures such as the heart, trachea, oesophagus, and major blood vessels.

At KIMSHEALTH, mediastinal node evaluation is performed using evidence-based, guideline-aligned techniques to ensure accurate diagnosis while minimising risk and recovery time.

Why Mediastinal Lymph Node Sampling is Important

Accurate assessment of mediastinal lymph nodes is critical for cancer staging, treatment planning, and prognosis—especially in patients with suspected or confirmed lung cancer.

International guidelines recommend pathological sampling of mediastinal nodes in:

• Early-stage lung cancer where imaging may miss microscopic spread
• Suspected stage II or III lung cancer
• Patients with enlarged or PET-positive mediastinal nodes
• Suspected lymphoma, tuberculosis, sarcoidosis, or metastatic cancers

What is FNAC vs FNAB?

FNAC (Fine Needle Aspiration Cytology)

• Collects cells for cytology
• Often sufficient for cancer staging and infection diagnosis

FNAB (Fine Needle Aspiration Biopsy)

• Collects a small tissue core
• Helpful when more architectural detail is needed (e.g., lymphoma)

Both are safe, needle-based techniques performed under real-time imaging guidance.

How Mediastinal Lymph Node FNAC/FNAB is Performed

Common Minimally Invasive Approaches

The choice depends on lymph node location, prior surgeries, and clinical context.

1. Endobronchial Ultrasound–Guided FNAC (EBUS-TBNA)

• Performed via the airway using a bronchoscope with ultrasound
• Accesses nodes near the trachea and bronchi (stations 1–4, 7, 10–12)
• Most commonly used first-line method
• No surgical incision

2. Endoscopic (Oesophageal) Ultrasound–Guided FNAC (EUS-FNA)

• Performed through the oesophagus
• Samples subcarinal, paraoesophageal, and pulmonary ligament nodes
• Often complementary to EBUS

3. Surgical Approaches (Selected Cases Only)

• Mediastinoscopy
• Thoracoscopy (VATS)
• Anterior mediastinotomy (Chamberlain procedure)

Used when needle-based methods are non-diagnostic or not feasible.

What to Expect During the Procedure

• Usually performed as a day-care procedure
• Sedation or general anaesthesia may be used
• Real-time ultrasound ensures precision and safety
• Multiple samples may be taken to improve diagnostic accuracy
• Patients typically go home the same day

Safety and Risks

Mediastinal FNAC/FNAB is considered very safe, especially with ultrasound guidance.

Possible but Uncommon Risks:

• Minor bleeding
• Temporary sore throat or cough
• Infection (rare)
• Pneumothorax (very rare with needle techniques)

Serious complications are significantly lower than with open surgical biopsies.

Accuracy and Outcomes

• Diagnostic accuracy exceeds 90% in experienced centres
• Often avoids the need for surgery
• Enables faster treatment decisions
• Essential for selecting surgery, chemotherapy, radiation, or targeted therapy

Why Choose KIMSHEALTH?

• Advanced EBUS and EUS expertise
• Multidisciplinary lung cancer team
• On-site pathology support
• International guideline–driven care
• Focus on patient safety, comfort, and accuracy

Call to Action

If you or a loved one has suspected lung cancer, enlarged mediastinal lymph nodes, or unexplained chest findings, early and accurate diagnosis is critical.

👉 Book a consultation at KIMSHEALTH today 📞 Call:

Early diagnosis saves time, avoids unnecessary surgery, and improves outcomes.