The value of ultrasound-guided biopsy of fluorodeoxy-glucose positron emission tomography (FDG-PET)-positive supraclavicular lymph nodes in patients with suspected lung cancer

BMC Medical Imaging

Research Article

Franziska Aebersold Keller¹  Oliver Gautschi²  Ujwal Bhure³  Maria del Sol Pèrez-Lago³  Katharina Tornquist³  Klaus Strobel³  Lennart Werner³  Justus Egidius Roos³ 

[1] Department of Pathology, Cantonal Hospital, Lucerne, Switzerland;Department of Pathology, Cantonal Hospital, Lucerne, Switzerland;Department of Medical Oncology, Cantonal Hospital, Lucerne, Switzerland;Department of Radiology and Nuclear Medicine, Cantonal Hospital, Spitalstrasse 13, 6000, Lucerne, Switzerland;

关键词: NSCLC;    PET/CT;    Supraclavicular lymph nodes;    US guided biopsy;    Staging;   

DOI  :  10.1186/s12880-017-0214-8

 received in 2016-12-29, accepted in 2017-07-03,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAccurate lymph node staging is essential for adequate prognostication and therapy planning in patients with non-small cell lung cancer (NSCLC). FDG-PET/CT is a sensitive tool for the detection of metastases, including non-palpable supraclavicular lymph node (SCLN) metastases. Histological proof of metastatic spread and mutation analysis is crucial for optimal staging and therapy. The aim of this study was to investigate the value of ultrasound-guided fine needle aspiration cytology (FNAC) and core biopsy (CB) of FDG active, non-palpable SCLN’s in patients with suspicion for lung cancer.MethodsTwelve consecutive patients with suspected lung cancer and FDG-positive SCLN underwent FNAC (n = 11) and/or CB (n = 10) and were included and evaluated retrospectively in this study. Cytologic and/or histologic evaluation was performed to confirm initially suspected diagnosis (lung cancer), to confirm N3 stage, and to screen for driver mutations in lung adenocarcinoma.ResultsFNAC alone showed diagnostic success in 11/11 cases (100%), CB alone in 9/10 patients (90%), and the combination of both procedures was successful in 12/12 cases (100%). Lymph node metastases from NSCLC (7 adenocarcinoma, 2 squamous cell carcinoma) could be confirmed in 9 patients. Other diagnoses were small cell lung cancer (SCLC), breast cancer and sarcoidosis. There was enough material for immunhistochemistry in all patients. For molecular testing, material from this lymph node biopsies and lung biopsy was used. In two patients with adenocarcinoma of the lung driver mutations were detected (EGFR Exon 19 deletion and ALK rearrangement) out of the lymph node metastasis.ConclusionsUS-guided combined FNAC and CB of FDG positive supraclavicular lymph nodes in patients with suspected lung cancer is a safe and effective procedure to confirm N3-stage and to obtain representative material for molecular testing.

【 授权许可】

CC BY   
© The Author(s). 2017