Abstract
Scalene node biopsy (SNB) has been utilized for diagnostic and/or staging purposes in various primary and metastatic chest diseases. In this clinicopathological study, SNB was reassessed with regard to its indication and diagnosis. During the period between 1961 and 1983, 99 patients with chest diseases received SNB at our institution. The diagnosis prior to SNB consisted of 84 cases of primary lung cancer, 4 cases of metastatic lung cancer, 3 cases of mediastinal tumor and 8 cases of sarcoidosis. Satisfactory specimens were obtained from 94% of these patients and the complication rate was only 2%. Among benign thoracic lesions, sarcoidosis is best indicated for SNB. It can be diagnosed 100% accurately if adequate specimens are provided, preferably from the right side. It was diagnostic in 35% of the primary lung cancer cases. The accuracy rates were 65% for adenocarcinoma, 12% for squamous cell carcinoma and 50% for small cell carcinoma, respectively. Palpable scalene turned out to be 100% positive for metastases, while only 16% of nonpalpable nodes were proved to contain carcinoma. This study suggests that indication of SNB should be individualized.
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