What is the anatomy of the mediastinum relevant to lymphomas, endocrine, mesenchymal, and other tumors of the mediastinum?

Updated: Feb 16, 2021
  • Author: Mary C Mancini, MD, PhD, MMM; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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In determining the location of specific mediastinal masses, the portion of the thorax defined as the mediastinum extends from the posterior aspect of the sternum to the anterior surface of the vertebral bodies and includes the paravertebral sulci. The mediastinum is limited bilaterally by the mediastinal parietal pleura and extends from the diaphragm inferiorly to the level of the thoracic inlet superiorly.

For better descriptive localization of specific lesions, the mediastinum has traditionally been artificially subdivided into three spaces or compartments as follows:

  • The anterior compartment, or anterior mediastinum, extends from the posterior surface of the sternum to the anterior surface of the pericardium and great vessels; it normally contains the thymus gland, adipose tissue, and lymph nodes; the blood supply of almost all intrathoracic thyroid goiters is derived from the inferior thyroid arteries
  • The middle compartment, or middle mediastinum, is located between the posterior limit of the anterior compartment and the anterior longitudinal spinal ligament; it contains the heart, pericardium, ascending and transverse portions of the aorta, brachiocephalic vessels, main pulmonary arteries and veins, superior cvena cava (SVC), inferior vena cava (IVC), trachea and mainstem bronchi, and numerous lymph nodes
  • The posterior compartment, or posterior mediastinum, comprises the area posterior to the heart and trachea and includes the paravertebral sulci; it contains the descending thoracic aorta and ligamentum arteriosum, esophagus, thoracic duct, azygos vein, and numerous neural structures (eg, autonomic ganglion and nerves, lymph nodes, and adipose tissue)

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