Abstract

I appreciate the interest shown by Dr Sawabata [1Sawabata N. Detecting metastasis of lung cancer in mediastinal lymph nodes the discrepancy between cytology and histology (letter).Ann Thorac Surg. 2006; 81: 1547Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar] in our report on imprint cytology for mediastinal node metastasis [2Okubo K. Kato T. Hara A. Yoshimi N. Takeda K. Iwao F. Imprint cytology for detecting metastasis of lung cancer in mediastinal lymph nodes.Ann Thorac Surg. 2004; 78: 1990-1993Abstract Full Text Full Text PDF Scopus (13) Google Scholar]. In our study, the evaluation of mediastinal node metastasis was not for surgical stump but for staging of lung cancer using the imprint technique. Mediastinal node biopsies were done through the conventional cervical mediastinoscopy in all patients. Therefore no contamination occurs through the pleural space. Pleural effusion, lavage cytology, or micrometastasis in the pleural space never affected the results of mediastinal node metastasis. Even if the malignant cells were identified from contamination through the approach for a specific node or from the lymph duct, the patient still had mediastinal node metastasis in our study. The discrepancy between the cytology and histology for malignancy needs to be carefully evaluated. Some pathologists say that all positive touch imprints and histology findings were considered to be true positive [3Lee A. Krishnamurthy S. Sahin A. Symmans W.F. Hunt K. Sneige N. Intraoperative touch imprint of sentinel lymph nodes in breast carcinoma patients.Cancer. 2002; 96: 225-231Crossref PubMed Scopus (62) Google Scholar]. In our study, the same pathologist made the final diagnosis of node metastasis after obtaining both results of cytology and histology. Detecting Metastasis of Lung Cancer in Mediastinal Lymph Nodes: The Discrepancy Between Cytology and HistologyThe Annals of Thoracic SurgeryVol. 81Issue 4PreviewDr Okubo and his colleagues reported on the efficacy of stump cytology technique for diagnosing mediastinal lymph node metastasis [1]. Their conclusion is that imprint cytology for detecting metastasis of lung cancer in mediastinal nodes has high sensitivity and accuracy and is no less useful than a histologic examination. Full-Text PDF

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