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I think the comments about obtaining a histological diagnosis in
these cases are rather out-of-date.With modern immunohistochemistry an
18guage core biopsy obtained under CT or ultrasound guidance is quite
adequate to type lymphomas and the commoner carcinomas without the need
for node excision or mediastinoscopy. Indeed the latter may be
particularly hazardous in patients with such big mediastinal masses as the
airway may be difficult to maintain under general anaesthesia.
In Plymouth we have been doing mediastinal core biopsies under CT for 20
years with audited success rates of over 90% and no significant