Mediastinal Pathology

The mediastinum is a hollow space within the thoracic cavity that may give rise to a wide spectrum of tumoral conditions from the benign to the intermediate to the highly malignant neoplasms. In addition, other inflammatory and infectious conditions may also arise in this space, which renders the practice of mediastinal pathology, almost a general surgical pathology practice. However, there are numerous mediastinal conditions that are important not only for diagnosis but also for treatment and clinical outcome. Due to the unusual location and because of the complexity of the tumors occurring in the mediastinum, there are only a few experts in this particular anatomic area. In fact, there are no more than 3-4 individuals worldwide with enough experience to properly diagnose, classify, and make treatment suggestions when these tumors arise in the mediastinum.
More recent developments in tumor diagnosis and classification have created a vacuum in the general pathologist who often is confronted with this pathology and becomes uneasy about the specifics. For instance, recent developments in tumor pathology have led to the classification and staging of mediastinal tumors in more innovative ways that are in need of proper highlighting. Needless to say, even though there are a few publications on mediastinal pathology, the books are either obsolete or incomplete, in addition of providing superficial knowledge. Unfortunately and with all due respect to the authors of those publications, neither of those books is written by experts in the area. Rather the books were written out of the lack of information in mediastinal pathology. Even the World Health Organization (WHO) publication, which is truly more on lung and pleural neoplasms, has inserted in its contents a portion of mediastinal tumors, such portion not only is superficial and incomplete but also at least highly controversial if not flat out incorrect. .
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