Diagnostic value of scalene node biopsy in pulmonary tuberculosis

In 288 cases patients proved to have pulmonary tuberculosis were subjected to scalene node biopsy in an attempt to assess the diagnostic value of the procedure. Tuberculous histopathology in the scalene nodes was obtained in 72 cases (26%) out of a total of 276 in which glands were obtained. Even when acid-fast bacilli were absent in sputum (smear examination) the scalene nodes confirmed the diagnosis in 23% of cases. The corresponding figure for those with acid-fast bacilli in the sputum was 30%. Previous chemotherapy did not appear to affect the diagnostic value of the procedure, nor did the extent of involvement of the lung parenchyma. ‘Sinus catarrh’ in 84 instances were taken to be diagnostically inconclusive. In no instances did the scalene nodes suggest a tuberculosis. We suggest that scalene node biopsy may be helpful in some patients when the diagnosis of pulmonary tuberculosis is in doubt.