The historical, anatomical, and technical aspects of mediastinoscopy are reviewed. The indications for its use, as well as the attendant low morbidity and minimal mortality, are presented. Extension of these indications to include patients with Hodgkin's disease has been examined through our personal experience, from questinnaires sent to leading thoracic surgeons and to directors of lymphoma treatment centers, and by review of the literature.

Only a small percentage of mediastinoscopies are performed to determine the presence of lymphoma or Hodgkin's disease. The procedure does not appear to be as helpful in staging, if applied on a routine a basis, as exploratory laparotomy. It may be helpful, however, in determining the cause of recurrent mediastinal enlargement in patients with previously treated Hodgkin's disease.

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