title: Axillary lymph node metastasis in lung cancer.
abstract: OBJECTIVE
  Axillary lymph node metastasis (ALNM) from lung cancer is rare. Its prognosis and effective treatments remain unknown. To evaluate clinicopatholgical characteristics of such lung cancer patients, we performed a retrospective study of them, who had ALNM at the time of initial presentation or developed ALNM in their clinical courses.
  
  
  METHODS
  We reviewed the medical records and pathological reports of all patients at our division who had a diagnosis of primary lung cancer from January 1985 through August 2007.
  
  
  RESULTS
  Ten (0.75%) of 1,340 patients had ALNM. In eight of them, ALNM was detected at the time of initial diagnosis, and two patients developed ALNM in their clinical courses. Lymphatic metastasis to mediastinum was evident in all patients. Supraclavicular and cervical lymph nodes were involved in five and three patients, respectively. One patient had direct chest wall invasion from the lung. Three patients had distant metastases other than axillary or cervical lymph nodes. Four patients received systemic chemotherapy, and another four patients received palliative chest irradiation or supportive care because of their poor performance status. Median survival time of 8 patients who were diagnosed as having ALNMs at initial presentation was 7 months.
  
  
  CONCLUSIONS
  The most likely mechanism for axillary node involvement is intercostal lymphatics via spread from mediastinal lymph node metastasis. Routine palpation of the axillae is recommended if chest wall invasion, mediastinal and/or supraclavicular lymph nodes are found either at initial presentation or at follow-up of patients.
authors.affiliation: Division of Respiratory Medicine, Institute of Clinical Medicine, University of Tsukuba, Tsukuba-city, Ibaraki, 305-8575, Japan. hirosato@md.tsukuba.ac.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Satoh
authors.forename: Hiroichi
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Katsunori
authors.initials: K
authors.lastname: Kagohashi
authors.forename: Koichi
authors.initials: K
authors.lastname: Kurishima
authors.forename: Kiyohisa
authors.initials: K
authors.lastname: Sekizawa
mesh_terms: D000368:Aged; D001365:Axilla; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies