Ultrasonography and ultrasonographically guided fine‐needle aspiration biopsy of impalpable cervical lymph nodes in patients with non‐small cell lung cancer

Background. Neck ultrasonography (US) and ultrasonographically guided fine‐needle aspiration (UGFNA) cytologic examination were used in the staging work‐up of 51 consecutive patients with non‐small cell lung cancer (NSCLC) with clinically impalpable cervical lymphadenopathy. Methods. All patients had chest radiography, fiberoptic bronchoscopic examination, computed tomography (CT) scans of the chest and abdomen, bone scan, and US of the abdomen and the neck. Results. Six patients (12%) were found to have cervical lymph nodes by neck US. The cytologic examination of the lymph node aspirates obtained from UGFNA confirmed the metastasis. The clinical stage thus was changed from Stage IIIa to Stage IIIb in one patient. In the other five patients, UGFNA of cervical lymph nodes prevented more invasive diagnostic procedures. Conclusions. This preliminary study shows that neck US and UGFNA of lymph nodes may be helpful in the pretreatment evaluation of patients with NSCLC with impalpable cervical lymph nodes. However, additional study is needed to confirm this result.