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

Kendirlinan, Reşat; Özkan, Gülçihan; Bayram, Mehmet; Bakan, Nur Dilek; Tutar, Mehmet; Gür, Aygün; Camsari, Gungor

doi:10.1186/2049-6958-6-4-220

Cited by 18 publications

(12 citation statements)

References 15 publications

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“…Davis et al reported the frequency of cervical lymph node involvement in patients with lung cancer, to vary from 1.5% to 32%, possibly because the term “cervical node” was used without site specification. High resolution ultrasound is extremely useful for imaging these patients . Prosch et al assessed the utility of ultrasound evaluation and ultrasound‐guided fine‐needle aspiration biopsy for the diagnosis and staging of patients with lung cancer.…”

Section: Specific Primary Tumor Sitesmentioning

confidence: 99%

Cervical lymph node metastases from remote primary tumor sites

et al. 2015

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Although most malignant lymphadenopathy in the neck represent lymphomas or metastases from head and neck primary tumors, occasionally, metastatic disease from remote, usually infraclavicular, sites presents as cervical lymphadenopathy with or without an obvious primary tumor. In general, these tumors metastasize to supraclavicular lymph nodes, but occasionally may present at an isolated higher neck level. A search for the primary tumor includes information gained by histology, immunohistochemistry, and evaluation of molecular markers that may be unique to the primary tumor site. In addition, 18F-fluoro-2-deoxyglocose positron emission tomography combined with CT (FDG-PET/CT) has greatly improved the ability to detect the location of an unknown primary tumor, particularly when in a remote location. Although cervical metastatic disease from a remote primary site is often incurable, there are situations in which meaningful survival can be achieved with appropriate local treatment. Management is quite complex and requires a truly multidisciplinary approach.

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Section: Specific Primary Tumor Sitesmentioning

confidence: 99%

Cervical lymph node metastases from remote primary tumor sites

et al. 2015

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“…Presence of lower cervical lymphadenopathy indicates N3 disease corresponding to at least stage IIIB, and upper cervical lymphadenopathy represents M1b disease -stage IV lung cancer [2]. Neck ultrasound (NUS) routinely performed in patients with mediastinal lymphadenopathy has been shown to reveal metastases to neck lymph nodes in 40-50% of cases [3,4].…”

Section: Introductionmentioning

confidence: 99%

PET and Neck Ultrasound for the Detection of Cervical Lymphadenopathy in Patients with Lung Cancer and Mediastinal Lymphadenopathy

Ahmed¹,

Flannery²,

Daneshvar³

et al. 2018

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Background: Cervical lymph nodes are frequently involved in patients with lung cancer and indicate inoperability. Some guidelines recommend neck ultrasound (NUS) in patients with bulky mediastinal lymphadenopathy. Positron emission tomography (PET) is indicated for patients with potentially curable disease. Objectives: We aimed to assess the diagnostic yield of NUS and the diagnostic accuracy of PET for cervical lymphadenopathy in this group with a high pre-test probability of N3 disease. Methods: Records of all patients with lung cancer who underwent an NUS over a consecutive 5-year period were reviewed. Only patients with mediastinal lymphadenopathy on computerised tomography (CT) were included. The diagnostic accuracy of PET was assessed with NUS-guided fine needle aspiration cytology used as the reference test. Results: During the study period, 123 patients met the inclusion criteria. Malignant cervical lymphadenopathy was confirmed in 49/123 (39.8% [95% CI 31.1–49.1]). PET-CT had a specificity of 81.1%, sensitivity of 87.5%, negative predictive value of 96.8% and positive predictive value of 50% for the detection of cervical lymphadenopathy, and it contributed no additional staging information in the neck area. Overall, PET led to a change in management in only 2.2% of cases. Conclusion: A significant proportion of patients with lung cancer and mediastinal lymphadenopathy have cervical lymphadenopathy detected by NUS. In this group of patients, PET offers minimal additional value in staging and management.

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“…Other studies in non-palpable supraclavicular nodes, detected and aspirated with US, confirmed these high rates of metastatic disease in lung cancer but the investigators did not perform PET imaging [55,56]. …”

Section: Us As a Sampling Guidementioning

confidence: 81%

Percutaneous Ultrasonography as Imaging Modality and Sampling Guide for Pulmonologists

Stigt

Groen

2014

Respiration

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Ultrasound (US) imaging is gradually progressing into common practice in contemporary pulmonology. Its main applications are to determine the presence and amount of pleural effusions and to guide subsequent treatment interventions. Guidelines recommend the use of US for these indications. Training programs are organized and competency levels are formulated. Image guidance with US to obtain specimens for pathologic and/or microbiological analysis is less extensively practiced by pulmonologists but it is an important tool for tumour staging and diagnosing diseases. Lung tumours in contact with the pleural surface, pleural thickenings, mediastinal tumours and chest wall tumours are conceivable indications for pulmonologists to approach with the help of US visualization. Moreover, sampling of chest disease-related extrathoracal lesions may also be regarded as the working field of the pulmonologist. For example, supraclavicular and axillar lymph node metastasis, and also soft tissue and bone metastases, are lesions encountered during dissemination tests. US-guided biopsy provides not only a diagnosis, but also gives information on the stage of disease in sometimes inaccessible primary lesions. US-guided sampling increases diagnostic efficacy and safety and enables very precise performance of fine-needle aspirations as well as tissue core biopsies.

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

Cited by 18 publications

References 15 publications

Cervical lymph node metastases from remote primary tumor sites

Cervical lymph node metastases from remote primary tumor sites

PET and Neck Ultrasound for the Detection of Cervical Lymphadenopathy in Patients with Lung Cancer and Mediastinal Lymphadenopathy

Percutaneous Ultrasonography as Imaging Modality and Sampling Guide for Pulmonologists

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