Biopsy of nonpalpable scalene lymph nodes in carcinoma of the lung.

Abstract

Bilateral scalene node biopsies were done in 341 consecutive private patients with histologically proved carcinoma of the lung. Biopsies were positive in 51 of 55 (93 per cent) of patients with palpable nodes and in 68 of 286 (23.8 per cent) with nonpalpable nodes. There were 3 minor and no major complications in the series. in previous reports from the literature, biopsies were positive in 475 of 576 (83 per cent) of patients with palpable nodes and in 452 of 2,254 (20.1 per cent) with nonpalpable nodes. Although biopsy of palpable nodes is standard practice everywhere, the importance of routine biopsy of nonpalpable scalene nodes has not been properly stressed. Because positive scalene node biopsy indicates inoperability in carcinoma of the lung, the procedure identifies a large group of patients with incurable disease in whom major surgical treatment should be avoided. Choosing the ipsilateral side for biopsy of nonpalpable nodes is unwarranted. Bilateral biopsies should be done in all patients in whom...