title: Ultrasound guided fine-needle aspiration biopsy of metastases in nonpalpable supraclavicular lymph nodes in lung cancer patients.
abstract: OBJECTIVE
  To assess frequency and significance of enlarged nonpalpable supraclavicular lymph nodes with routine ultrasound (US) evaluation and US-guided fineneedle aspiration biopsy (FNAB) for the diagnosis and staging of patients with lung cancer.
  
  
  METHODS
  106 consecutive patients with lung cancer and nonpalpable supraclavicular lymph nodes were evaluated with cervical US for the presence of pathological lymph nodes. FNAB was performed in patients with nodes with short-axis > 5 mm, rounded shape and missing echogenic hilum.
  
  
  RESULTS
  27 (25.5%) patients had enlarged supraclavicular lymph nodes on US. Fourteen patients (13.2%) had cytologically proven lymph node involvement. Supraclavicular lymph node metastasis was more frequent in patients with mediastinal invasion (p = 0.0001) and patients with enlarged lymph nodes on upper paratracheal stations on thorax CT (p = 0.0001). No relation was found between supraclavicular lymph node involvement and T stage (p = 0.27), distant metastasis (p = 0.50) or histological type (p = 0.80). Three patients were upstaged from IIIA to IIIB status. US-guided FNAB was the only diagnostic method in 2 patients.
  
  
  CONCLUSIONS
  US-guided FNAB is a simple and safe procedure which can document N3 stage of disease in lung cancer patients. Thereby more invasive and expensive diagnostic procedures can be avoided in selected lung cancer patients.
authors.affiliation: Sivas Numune Hospital, Department for Chest Diseases, Sivas, Turkey. drmehmetbayram@yahoo.com.
authors.forename: Resat
authors.initials: R
authors.lastname: Kendirlinan
authors.forename: Gülcihan
authors.initials: G
authors.lastname: Ozkan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bayram
authors.forename: Nur Dilek
authors.initials: ND
authors.lastname: Bakan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tutar
authors.forename: Aygün
authors.initials: A
authors.lastname: Gür
authors.forename: Güngör
authors.initials: G
authors.lastname: Camsari