Ultrasound guided fine-needle aspiration biopsy of metastases in nonpalpable supraclavicular lymph nodes in lung cancer patients

Resat Kendirlinan; Gülcihan Özkan; Mehmet Bayram; Nur Dilek Bakan; Mehmet Tutar; Aygün Gür; Güngör Camsari

doi:10.4081/mrm.2011.443

Ultrasound guided fine-needle aspiration biopsy of metastases in nonpalpable supraclavicular lymph nodes in lung cancer patients

Authors

Resat Kendirlinan Niksar State Hospital, Department for Chest Diseases, Tokat
Gülcihan Özkan Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Chest Diseases Department, Istanbul
Mehmet Bayram Sivas Numune Hospital, Department for Chest Diseases, Sivas
Nur Dilek Bakan Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Chest Diseases Department, Istanbul
Mehmet Tutar Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Radiology Department, Istanbul
Aygün Gür Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Chest Diseases Department, Istanbul,
Güngör Camsari Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Chest Diseases Department, Istanbul

DOI: https://doi.org/10.4081/mrm.2011.443

Keywords:

Diagnosis, fine-needle aspiration biopsy, lung can- cer, staging, ultrasonography

Abstract

Background and objectives: To assess frequency and signifi- cance of enlarged nonpalpable supraclavicular lymph nodes with routine ultrasound (US) evaluation and US-guided fine- needle aspiration biopsy (FNAB) for the diagnosis and staging of patients with lung cancer.

Materials and methods: 106 consecutive patients with lung cancer and nonpalpable supraclavicular lymph nodes were evaluated with cervical US for the presence of pathological lymph nodes. FNAB was performed in patients with nodes with short-axis > 5 mm, rounded shape and missing echogenic hilum.

Results: 27 (25.5%) patients had enlarged supraclavicular lymph nodes on US. Fourteen patients (13.2%) had cytologically proven lymph node involvement. Supraclavicular lymph node metastasis was more frequent in patients with medi- astinal invasion (p = 0.0001) and patients with enlarged lymph nodes on upper paratracheal stations on thorax CT (p = 0.0001). No relation was found between supraclavicular lymph node involvement and T stage (p = 0.27), distant metastasis (p = 0.50) or histological type (p = 0.80). Three patients were upstaged from IIIA to IIIB status. US-guided FNAB was the only diagnostic method in 2 patients.

Conclusion: US-guided FNAB is a simple and safe procedure which can document N3 stage of disease in lung cancer patients. Thereby more invasive and expensive diagnostic procedures can be avoided in selected lung cancer patients.