Mediastinum (ITMIG classification)

Last revised by Dr Francis Deng on 12 Mar 2019

The International Thymic Malignancy Interest Group (ITMIG) classification of mediastinal compartments was developed to reflect a division of the mediastinum based on cross-sectional imaging. It was in part an effort to consolidate prior discrepant classification systems in use by different medical specialties. A working group composed of approximately 225 experts in thoracic surgery, medical oncology, diagnostic radiology, and pathology were tasked with forming a practical system for anatomic classification which unified the various systems.

Classification

The ITMIG classification divides the mediastinum into three compartments: prevascular, visceral and paravertebral 1,2.

Prevascular compartment
Boundaries
Contents
Visceral compartment
Boundaries
  • superior: thoracic inlet
  • inferior: diaphragm
  • anterior: posterior boundary of the prevascular compartment
  • posterior: a vertical line connecting a point on each thoracic vertebral body 1 cm posterior to its anterior margin (visceral-paravertebral compartment boundary line)
Contents
Paravertebral compartment
Boundaries
  • superior: thoracic inlet
  • inferior: diaphragm
  • anterior: posterior boundaries of the visceral compartment
  • posterolateral: vertical line against the posterior margin of the chest wall at the lateral margin of the thoracic spine
Contents

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