Abstract:
STUDY OBJECTIVE:To reevaluate whether it is possible to reliably differentiate malignant mediastinal lymph nodes from benign nodes by size, and to determine the frequency of metastases to normal-sized mediastinal lymph nodes that directly affects the sensitivity for detecting malignant mediastinal lymph nodes (N2 nodes) on CT. DESIGN:Prospective study of patients with non-small cell lung cancer. SETTING:Department of Radiology and First Department of Surgery, Yamaguchi University School of Medicine. PATIENTS:We examined 40 patients with non-small cell lung cancer, who underwent thoracotomy because of operable stage (stage I, II, IIIA) in preoperative staging, using CT and transesophageal echocardiography (TEE). INTERVENTIONS:None. MEASUREMENTS AND RESULTS:Lymph nodes 10 mm or greater in short-axis diameter on CT and TEE were considered abnormal. Furthermore, lymph node size was measured by TEE and nodal specimens in long- and short-axis diameter in each patient. Two hundred eight mediastinal lymph nodes were dissected and N2 nodes were present in 28% of patients (11/40); in 7 of these 11 patients (64%), mediastinal lymph node metastases were misdiagnosed on CT because of normal-sized N2 nodes. Furthermore, in 73% of N2 nodes, nodal size was normal on TEE. There were no significant difference in both diameters between malignant mediastinal lymph nodes and benign nodes on TEE and nodal specimens. CONCLUSIONS:It is not possible to reliably differentiate malignant mediastinal nodes from benign nodes by size alone, and we should be aware of high frequency of normal-sized N2 nodes in patients with operable stage of lung cancer.
journal_name
Chestjournal_title
Chestauthors
Arita T,Matsumoto T,Kuramitsu T,Kawamura M,Matsunaga N,Sugi K,Esato Kdoi
10.1378/chest.110.4.1004subject
Has Abstractpub_date
1996-10-01 00:00:00pages
1004-8issue
4eissn
0012-3692issn
1931-3543pii
S0012-3692(15)46438-4journal_volume
110pub_type
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