Abstract
Cervical mediastinoscopy (CM) is considered to be the gold standard for evaluating mediastinal lymph nodes. The aim of this study was to determine the diagnostic yield of computed tomography (CT) and CM for detecting enlarged mediastinal lymph nodes in non-malignant pulmonary diseases. We retrospectively investigated the correlation and differentiation between chest CT and CM findings in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), in 30 patients with granulomatous lung disease diagnosed by CM and isolated enlarged lymph nodes seen on CT scans. Biopsy tissues from the lymph nodes in stations right, 1, 2, 3, 4, and 7, were obtained for pathological examination. The 30 patients comprised 11 men (mean age 47.1 ± 18.4 years) and 19 women (mean age 44.2 ± 14.0 years). Radiological examination showed that the diagnostic value of stations 2 and 4 was particularly high. Thus, when CM is used for diagnostic purposes, the small lymph nodes in station 1, obtained by careful dissection of the higher mediastinal region, can be helpful. Generally, there is no absolute consistency between the findings of CM and CT. For this reason, obtaining samples from each station regardless of CT findings is recommended.
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References
H Porte D Roumilhac L Eraldi C Cordonnier P Puech A Wurtz (1998) ArticleTitleThe role of mediastinoscopy in the diagnosis of mediastinal lymphadenopathy Eur J Cardiothorac Surg 2 196–9 Occurrence Handle10.1016/S1010-7940(97)00324-2
H Yanardag M Caner K Kaynak S Uygun S Demirci T Karayel (2006) ArticleTitleClinical value of mediastinoscopy in the diagnosis of sarcoidosis: an analysis of 68 cases Thorac Cardiovasc Surg 3 198–201 Occurrence Handle10.1055/s-2005-872996
CF Mountain CM Dresler (1997) ArticleTitleRegional lymph node classification for lung cancer staging Chest 6 1718–23
S Elia C Cecere F Giampaglia G Ferrante (1992) ArticleTitleMediastinoscopy vs. anterior mediastinotomy in the diagnosis of mediastinal lymphoma: a randomized trial Eur J Cardiothorac Surg 6 361–5 Occurrence Handle1497928 Occurrence Handle10.1016/1010-7940(92)90173-U Occurrence Handle1:STN:280:By2A28%2FjsFc%3D
AJ Langen P Raijmakers I Riphagen MA Paul OS Hoekstra (2006) ArticleTitleThe size of mediastinal lymph nodes and its relation with metastatic involvement: a meta-analysis Eur J Cardiothorac Surg 1 26–9 Occurrence Handle10.1016/j.ejcts.2005.10.002
PJ Fultz RH Feins (2000) Radiological evaluation of lung cancer TW Shields J Lo Cicero RB Ponn (Eds) General thoracic surgery Lippincott Williams Wilkins Philedelphia 1283–98
GM Glazer (1985) ArticleTitleNormal mediastinal lymph nodes: number and size according to American Thoracic Society mapping AJR Am J Roentgenol 2 261–5
T Pirronti G Macis G Sallustio LM Minordi P Granone FM Vecchio et al. (2000) ArticleTitleEvaluation of the “N” factor in nonsmall cell lung cancer: correlation between computerized tomography and pathologic anatomy Radiol Med (Torino) 5 340–6
S Demircan IC Kurul IC Kurkcuoglu CD Yorgancilar (2006) ArticleTitleDiagnostic mediastinoscopy: analysis of 30 patients Turkish J Thorac Cardiovasc Surg 11 295–8 Occurrence Handle10.1053/j.optechstcvs.2006.11.001
G Specth (2000) Invasive diagnostic procedures TW Shields J Lo Cicero RB Ponn (Eds) General thoracic surgery Lippincott Williams Wilkins Philedelphia 273–84
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Sanli, A., Onen, A., Akkoclu, A. et al. Cervical Mediastinoscopy Versus Computed Tomography for Detecting Enlarged Mediastinal Lymph Nodes in Non-Cancerous Lung Diseases. Surg Today 38, 1–4 (2008). https://doi.org/10.1007/s00595-007-3554-0
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DOI: https://doi.org/10.1007/s00595-007-3554-0