Scalene lymph nodes in necropsies of malignant tumors. Analysis of one hundred sixty‐six cases

Scalene lymph nodes are valuable in the detection of disseminated malignant tumors, extrapulmonary malignancies as well as bronchogenic carcinomas. One hundred sixty‐six cases of malignant tumors from 588 necropsies were analyzed. Sixty‐four cases had metastasized to scalene lymph nodes (38.6%); of these, 47 were carcinomas and 17 were in the lymphoma—leukemia group. The 166 necropsies included 48 cases of primary carcinoma of lungs, 18 of which had metastasized to scalene lymph nodes; 47 cases of gastrointestinal malignancies, 11 having metastasized to scalene lymph nodes and 24 cases of genitourinary system malignancies, nine of which metastasized to scalene lymph nodes. Of 16 malignancies of the stomach and prostate gland 12 had metastasized to scalene nodes. The size of scalene nodes is no indication as to involvement by malignant tumor since 52% were 1.0 cm or less. Bilateral and contralateral scalene metastases are of sufficient occurrence to indicate the usefulness of bilateral scalene node examination, giving a diagnostic yield 12% higher than if only unilateral nodes were examined. Metastases to scalene nodes are a late manifestation of tumor dissemination.