Search tips
Search criteria 


Logo of thoraxThoraxVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Thorax. 1995 December; 50(12): 1267–1269.
PMCID: PMC1021349

Bronchogenic carcinoma: incidence of metastases to normal sized lymph nodes.


BACKGROUND--The incidence of metastases to mediastinal lymph nodes was evaluated in patients with normal sized mediastinal nodes on the computed tomographic (CT) scan who underwent thoracotomy. The use of hilar lymph nodes in predicting mediastinal lymph node metastases was also assessed. METHODS--Ninety patients with non-small cell lung cancer who later underwent thoracotomy wer prospectively examined by CT scanning. Lymph nodes with a short axis diameter of 10 mm or more were considered abnormal. RESULTS--Mediastinal lymph node metastases were present at thoracotomy in 19 patients (21%). In 14 these lymph node metastases were misdiagnosed because the nodes were normal in size on the CT scan. In only one of the 19 patients with N2 nodes was an N1 lymph node enlarged, and four of the 19 patients with N2 nodes had metastases to these mediastinal nodes without N1 disease ("skipping metastases"). CONCLUSIONS--Metastases in normal sized nodes seen on the CT scan are a major problem in staging. Hilar lymph nodes did not help to predict reliably the presence or absence of metastases to the mediastinal lymph nodes.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (547K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Pearson FG, DeLarue NC, Ilves R, Todd TR, Cooper JD. Significance of positive superior mediastinal nodes identified at mediastinoscopy in patients with resectable cancer of the lung. J Thorac Cardiovasc Surg. 1982 Jan;83(1):1–11. [PubMed]
  • Ratto GB, Mereu C, Motta G. The prognostic significance of preoperative assessment of mediastinal lymph nodes in patients with lung cancer. Chest. 1988 Apr;93(4):807–813. [PubMed]
  • Medina Gallardo JF, Borderas Naranjo F, Torres Cansino M, Rodriguez-Panadero F. Validity of enlarged mediastinal nodes as markers of involvement by non-small cell lung cancer. Am Rev Respir Dis. 1992 Nov;146(5 Pt 1):1210–1212. [PubMed]
  • Medina Gallardo JF, Borderas Naranjo F, Torres Cansino M, Rodriguez-Panadero F. Validity of enlarged mediastinal nodes as markers of involvement by non-small cell lung cancer. Am Rev Respir Dis. 1992 Nov;146(5 Pt 1):1210–1212. [PubMed]
  • Faling LJ, Pugatch RD, Jung-Legg Y, Daly BD, Jr, Hong WK, Robbins AH, Snider GL. Computed tomographic scanning of the mediastinum in the staging of bronchogenic carcinoma. Am Rev Respir Dis. 1981 Dec;124(6):690–695. [PubMed]
  • Osborne DR, Korobkin M, Ravin CE, Putman CE, Wolfe WG, Sealy WC, Young WG, Breiman R, Heaston D, Ram P, et al. Comparison of plain radiography, conventional tomography, and computed tomography in detecting intrathoracic lymph node metastases from lung carcinoma. Radiology. 1982 Jan;142(1):157–161. [PubMed]
  • Baron RL, Levitt RG, Sagel SS, White MJ, Roper CL, Marbarger JP. Computed tomography in the preoperative evaluation of bronchogenic carcinoma. Radiology. 1982 Dec;145(3):727–732. [PubMed]
  • McKenna RJ, Jr, Libshitz HI, Mountain CE, McMurtrey MJ. Roentgenographic evaluation of mediastinal nodes for preoperative assessment in lung cancer. Chest. 1985 Aug;88(2):206–210. [PubMed]
  • Staples CA, Müller NL, Miller RR, Evans KG, Nelems B. Mediastinal nodes in bronchogenic carcinoma: comparison between CT and mediastinoscopy. Radiology. 1988 May;167(2):367–372. [PubMed]
  • Webb WR, Gatsonis C, Zerhouni EA, Heelan RT, Glazer GM, Francis IR, McNeil BJ. CT and MR imaging in staging non-small cell bronchogenic carcinoma: report of the Radiologic Diagnostic Oncology Group. Radiology. 1991 Mar;178(3):705–713. [PubMed]
  • Gross BH, Glazer GM, Orringer MB, Spizarny DL, Flint A. Bronchogenic carcinoma metastatic to normal-sized lymph nodes: frequency and significance. Radiology. 1988 Jan;166(1 Pt 1):71–74. [PubMed]
  • Watanabe Y, Shimizu J, Tsubota M, Iwa T. Mediastinal spread of metastatic lymph nodes in bronchogenic carcinoma. Mediastinal nodal metastases in lung cancer. Chest. 1990 May;97(5):1059–1065. [PubMed]
  • Naruke T, Suemasu K, Ishikawa S. Lymph node mapping and curability at various levels of metastasis in resected lung cancer. J Thorac Cardiovasc Surg. 1978 Dec;76(6):832–839. [PubMed]
  • Yokoi K, Okuyama A, Mori K, Tominaga K, Miyazawa N, Takizawa I, Sasagawa M. Mediastinal lymph node metastasis from lung cancer: evaluation with Tl-201 SPECT--comparison with CT. Radiology. 1994 Sep;192(3):813–817. [PubMed]
  • Kerr KM, Lamb D, Wathen CG, Walker WS, Douglas NJ. Pathological assessment of mediastinal lymph nodes in lung cancer: implications for non-invasive mediastinal staging. Thorax. 1992 May;47(5):337–341. [PMC free article] [PubMed]

Articles from Thorax are provided here courtesy of BMJ Publishing Group