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J Thorac Oncol. 2014 Sep;9(9 Suppl 2):S97-101. doi: 10.1097/JTO.0000000000000292.

A modern definition of mediastinal compartments.

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*Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX; †Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan; ‡Department of Thoracic Surgery, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, Division of Thoracic Surgery, Continuum Cancer Centers of New York, New York, NY; §Department of Radiology, The University of Missouri-Kansas City, Saint Luke's Hospital of Kansas City, Kansas City, MO; ‖Department of Thoracic Surgery, Graduate School of Medicine, University of Tokyo, Bunkyo-ku, Tokyo, Japan; ¶Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA; and #Division of Thoracic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, CT.


Division of the mediastinum into compartments is used to help narrow the differential diagnosis of newly detected mediastinal masses, to assist in planning biopsy and surgical procedures, and to facilitate communication among clinicians of multiple disciplines. Several traditional mediastinal division schemes exist based upon arbitrary landmarks on the lateral chest radiograph. We describe a modern, computed tomography-based mediastinal division scheme, which has been accepted by the International Thymic Malignancy Interest Group as a new standard. This clinical classification defines a prevascular (anterior), a visceral (middle), and a paravertebral (posterior) compartment, with anatomic boundaries defined clearly by computed tomography. It is our intention that this definition be used in the reporting of clinical cases and the design of prospective clinical trials.

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