Detection and Diagnosis of Nonpalpable Supraclavicular Lymph Nodes in Lung Cancer at CT and US

Abstract

In many patients with lung cancer, chest CT that includes the neck base followed by US-guided sampling of enlarged supraclavicular lymph nodes is a simple and safe method for simultaneously establishing a tissue diagnosis and tumor nonresectability.

Lung cancer staging

“…Cervical ultrasonography has been shown to be a reliable investigation for detecting metastatic nodes from cancers of the head and neck [100 -102] and may be superior to even CT for detecting cervical nodal spread from lung cancer [103]. This combined cervical ultrasound and FNA approach has detected occult N3 cervical node metastases in 12% to 31% of lung cancer patients [103,104]; however, the criteria used to identify candidates for FNA was size alone on ultrasonography, which, as discussed earlier, is not a reliable indicator for malignant spread to a lymph node.…”

Percutaneous Ultrasonography as Imaging Modality and Sampling Guide for Pulmonologists

“…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]. …”

Radiology of Esophageal Cancer

“…Genel bir kural olarak çapı 1 cm'den büyük olan intratorasik ve abdominal lenf nodları kabul edilir (Resim 6). Supraklavikular lenf nodları için bu sınır 5 mm'dir (35,36). Boyut sınırı 1 cm kabul edildiğinde BT'nin duyarlılığı %30-60, özgüllüğü %60-80 arasında değişmektedir (28,37).…”