Profile of non-neoplasic mediastinal lymph nodes (NNLN) during the study of lung cáncer (LC)

Abstract

Introduction: Image and metabolic techniques (CT, PET and EBUS) during the study of lung cancer set the pathway to sampling mediastinal LN using EBUS. Discrimination between benign or malignant nature of LN is complex, because there are inconsistent data on morphological and metabolic expression of NNLN. Findings integration from the diferents techniques may guide the probability of benign nature, direct the sampling method and estabish the priority to mediastinoscopy (MED) Aim: The aim of our study was describe the NNLN profile compared with CT, PET/CT and the EBUS in patient with CP and correlate those findings Methods: Period:January 2012-March 2015. We include 86 LN of 81 patients (31 NNLN and 55 NLN) with LC. All patients dispose TC and PET before EBUS-TBNA. The analyzed variables: CT/PET findings, location and size of primary tumor and LN ultrasound signs of studied LN. All results were confirmed by MED. We analyze and correlate findings in NNLN and neoplastic LN Results: No difference in size, SUV and localization of primary tumor between NNLN and NLN. The mean (x - ) size in NNLN and NLN were 17,97 mm vs 23,64 mm respectively. The x - SUV were 4,05 in NNLN (16,5% with - SUVratio (LN SUV / primary Tu SUV) were 0.46 in NNLN (54,1 with r = -0.43 p=0,03) and positive in NLN (r=0.41, p=0,02). The central hilliar sign was the only benign sign, with low sensivity (28%) Conclusions: The presentation of NNLN in patients with LC is heterogeneous with no correlation between image and metabolic test. Lack of concordance in all techniques is suggestive of a benign nature.