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1. Gill KR, Ghabril MS, Jamil LH, Hasan MK, McNeil RB, Woodward TA, Raimondo M, Hoffman BJ, Hawes RH, Romagnuolo J, Wallace MB: Endosonographic features predictive of malignancy in mediastinal lymph nodes in patients with lung cancer. Gastrointest Endosc; 2010 Aug;72(2):265-71
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Endosonographic features predictive of malignancy in mediastinal lymph nodes in patients with lung cancer.
  • BACKGROUND: EUS is useful in determining mediastinal lymph node (LN) metastases in patients undergoing staging for lung cancer.
  • INTERVENTION: All mediastinal LNs were described according to size, shape, echogenicity, and margin characteristics.
  • EUS-guided FNA cytology was classified as benign or abnormal (suspicious/malignant).

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  • [Copyright] Copyright 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
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  • (PMID = 20541192.001).
  • [ISSN] 1097-6779
  • [Journal-full-title] Gastrointestinal endoscopy
  • [ISO-abbreviation] Gastrointest. Endosc.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R33 CA097875-03; United States / NCI NIH HHS / CA / CA097875-03; United States / NCI NIH HHS / CA / CA097875-01; United States / NCI NIH HHS / CA / R33 CA097875-04; United States / NCI NIH HHS / CA / CA097875-04; United States / NCI NIH HHS / CA / CA097875-05; United States / NCI NIH HHS / CA / R33 CA097875-05; United States / NCI NIH HHS / CA / R21 CA097875-01; United States / NCI NIH HHS / CA / R33 CA097875-02; United States / NCI NIH HHS / CA / CA097875-02; United States / NCI NIH HHS / CA / R33 CA097875
  • [Publication-type] Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Other-IDs] NLM/ NIHMS212817; NLM/ PMC2925200
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2. Lee BE, Redwine J, Foster C, Abella E, Lown T, Lau D, Follette D: Mediastinoscopy might not be necessary in patients with non-small cell lung cancer with mediastinal lymph nodes having a maximum standardized uptake value of less than 5.3. J Thorac Cardiovasc Surg; 2008 Mar;135(3):615-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Mediastinoscopy might not be necessary in patients with non-small cell lung cancer with mediastinal lymph nodes having a maximum standardized uptake value of less than 5.3.
  • The maximum standardized uptake value obtained with integrated fluorodeoxyglucose-positron emission tomography/computed tomography has been proposed to be a predictor of malignancy in mediastinal lymph nodes.
  • A recent study has also suggested that accuracy of integrated fluorodeoxyglucose-positron emission tomography/computed tomography might be improved by increasing the maximum standardized uptake value used for calling a lymph node positive from 2.5 to 5.3.
  • We tested the hypotheses that the maximum standardized uptake value is a predictor of individual lymph node metastasis in non-small cell lung cancer and that pathologic staging with mediastinoscopy might not be necessary in patients with a maximum standardized uptake value of less than 5.3 in their mediastinal lymph nodes.
  • METHODS: This is a retrospective review of 765 lymph nodes sampled from 110 patients in a single institution with biopsy-proved non-small cell lung cancer.
  • All patients underwent integrated fluorodeoxyglucose-positron emission tomography/computed tomography before biopsy or resection of their mediastinal lymph nodes.
  • All N2 lymph nodes were individually assessed according to station.
  • RESULTS: Twenty-one (19%) of 110 patients had N2 disease, and a total of 765 N2 lymph nodes were pathologically examined.
  • The mean and median maximum standardized uptake values for N2 nodes with metastatic disease were 9.2 (95% confidence interval, 7.0-11.4) and 7.2 (range, 2.2-25.8), respectively.
  • For benign N2 nodes, the mean and median maximum standardized uptake values were 1.5 (95% confidence interval, 1.4-1.6) and 1.0 (range, 1.0-9.6), respectively (P < .05).
  • CONCLUSIONS: The maximum standardized uptake value is a predictor of individual lymph node metastasis in non-small cell lung cancer.
  • More importantly, these results suggest that some patients with non-small cell lung cancer with a maximum standardized uptake value less than 5.3 in their N2 lymph nodes might be able to forego mediastinoscopy and proceed directly to thoracotomy.
  • This represents a significant change in the current management of standardized uptake value-positive mediastinal lymph nodes in non-small cell lung cancer.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / pathology. Lung Neoplasms / pathology. Lymph Nodes / pathology. Lymph Nodes / radionuclide imaging. Neoplasm Invasiveness / pathology. Positron-Emission Tomography
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biopsy, Needle. Cohort Studies. Female. Humans. Immunohistochemistry. Lymph Node Excision / methods. Male. Mediastinoscopy / methods. Middle Aged. Neoplasm Staging. Pneumonectomy / methods. Pneumonectomy / mortality. Predictive Value of Tests. Probability. Prognosis. Retrospective Studies. Risk Assessment. Statistics, Nonparametric. Survival Analysis. Treatment Outcome

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  • (PMID = 18329480.001).
  • [ISSN] 1097-685X
  • [Journal-full-title] The Journal of thoracic and cardiovascular surgery
  • [ISO-abbreviation] J. Thorac. Cardiovasc. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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3. Tournoy KG, Maddens S, Gosselin R, Van Maele G, van Meerbeeck JP, Kelles A: Integrated FDG-PET/CT does not make invasive staging of the intrathoracic lymph nodes in non-small cell lung cancer redundant: a prospective study. Thorax; 2007 Aug;62(8):696-701
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  • [Title] Integrated FDG-PET/CT does not make invasive staging of the intrathoracic lymph nodes in non-small cell lung cancer redundant: a prospective study.
  • The accuracy of FDG-PET scans for staging of lymph nodes is too low to replace invasive nodal staging.
  • METHODS: In a prospective study, the mediastinal and/or hilar lymph nodes in patients with proven NSCLC were investigated with integrated FDG-PET/CT scanning.
  • Pathological confirmation of all suspect lymph nodes was obtained to calculate the accuracy of the fusion images.
  • In addition, the use of the standardised uptake value (SUV) in the staging of intrathoracic lymph nodes was analysed.
  • RESULTS: 105 intrathoracic lymph node stations from 52 patients with NSCLC were characterised.
  • The prevalence of malignancy in the lymph nodes was 36%.
  • The sensitivity of the integrated FDG-PET/CT scan to detect malignant lymph nodes was 84% and its specificity was 85% (positive likelihood ratio 5.64, negative likelihood ratio 0.19).
  • SUV(max), SUV(mean) and the SUV(max)/SUV(liver) ratio were all significantly higher in malignant than in benign lymph nodes.
  • At a cut-off value of 1.5 for the SUV(max)/SUV(liver )ratio, the sensitivity and specificity to detect malignant lymph node invasion were 82% and 93%, respectively.
  • CONCLUSION: The accuracy of integrated FDG-PET/CT scanning is too low to replace invasive intrathoracic lymph node staging in patients with NSCLC.
  • The visual interpretation of the fusion images of the integrated FDG-PET/CT scan can be replaced by the quantitative variable SUV(max)/SUV(liver) without loss of accuracy for intrathoracic lymph node staging.
  • [MeSH-minor] Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Staging / methods. Positron-Emission Tomography / methods. Prospective Studies

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  • (PMID = 17687098.001).
  • [ISSN] 0040-6376
  • [Journal-full-title] Thorax
  • [ISO-abbreviation] Thorax
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
  • [Other-IDs] NLM/ PMC2117288
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4. Yang HX, Wu YL, Ding JA, Jiang GN, Zhou X, Chen C, Gao W, Chen G: [Detection of micrometastasis in mediastinal lymph nodes in operable non-small cell lung cancers]. Zhonghua Zhong Liu Za Zhi; 2006 May;28(5):368-70
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  • [Title] [Detection of micrometastasis in mediastinal lymph nodes in operable non-small cell lung cancers].
  • OBJECTIVE: Using the LUNX-mRNA as a marker and RT-PCR technique to assess mediastinal lymph nodes in patients with operable NSCLC, to evaluate at gene level the feasibility of this method in detection of micrometastasis in NSCLC and the necessity of systematic mediastinal lymphadenectomy during surgery.
  • The mediastinal lymph nodes were taken during operation.
  • Ten cases with benign lung disease were assayed by the same method as control.
  • RESULTS: Seventy one mediastinal lymph nodes were obtained from 20 patients, 8 (11.3%) of which showed histologically metastasis with HE staining, while 23 (32.4%) were LUNX-mRNA positive by RT-PCR, P < 0.001.
  • Micrometastasis was detected in 25.4% of all lymph nodes.
  • LUNX-mRNA was found to be positive in 23.6% of lymph nodes from 15 patients with stage I A-II B NSCLC compared with 62.5% from 5 patients with stage III NSCLC, with a significant difference (P = 0.003).
  • CONCLUSION: About 25.4% of mediastinal lymph nodes are with micrometastasis in patients with operable NSCLC.
  • Systematic mediastinal lymphadenectomy is necessary to deal with the regional lymph nodes during surgery.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / secondary. Lung Neoplasms / pathology. Lymph Node Excision. Lymph Nodes / pathology
  • [MeSH-minor] Adult. Aged. Female. Glycoproteins / biosynthesis. Glycoproteins / genetics. Humans. Lymphatic Metastasis. Male. Mediastinum. Middle Aged. Neoplasm Staging. Phosphoproteins / biosynthesis. Phosphoproteins / genetics. RNA, Messenger / biosynthesis. RNA, Messenger / genetics

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  • (PMID = 17045003.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] China
  • [Chemical-registry-number] 0 / BPIFA1 protein, human; 0 / Glycoproteins; 0 / Phosphoproteins; 0 / RNA, Messenger
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5. Wang F, Wang Z, Yao W, Xie H, Xu J, Tian L: Role of 99mTc-octreotide acetate scintigraphy in suspected lung cancer compared with 18F-FDG dual-head coincidence imaging. J Nucl Med; 2007 Sep;48(9):1442-8
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  • Thirteen of the 44 patients had benign lung lesions.
  • In the 31 patients with malignant tumors, all 38 abnormal lymph nodes in 20 patients showed abnormal high focal uptake of (18)F-FDG; only 7 patients with 10 regional lymph adenopathies showed moderate uptake of (99m)Tc-octreotide.
  • Tomographic (99m)Tc-octreotide scintigraphy had lower sensitivity for the detection of hilar and mediastinal lymph node metastasis compared with that of (18)F-FDG coincidence PET, but it had high sensitivity for the detection of remote metastatic lesions.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Metastasis

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  • (PMID = 17704242.001).
  • [ISSN] 0161-5505
  • [Journal-full-title] Journal of nuclear medicine : official publication, Society of Nuclear Medicine
  • [ISO-abbreviation] J. Nucl. Med.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / 99mTc-octreotide; 0 / Organotechnetium Compounds; 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18; RWM8CCW8GP / Octreotide
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6. Janssen J, Dietrich CF, Will U, Greiner L: Endosonographic elastography in the diagnosis of mediastinal lymph nodes. Endoscopy; 2007 Nov;39(11):952-7

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Endosonographic elastography in the diagnosis of mediastinal lymph nodes.
  • The aim of this study was to test the feasibility of this method in endosonography (EUS) of the dorsal mediastinum, and to compare the elastographic patterns of lymph nodes with results from EUS-guided fine-needle aspiration biopsy (FNAB).
  • PATIENTS AND METHODS: 50 consecutive patients undergoing EUS-guided FNAB of at least one paraesophageal lymph node were included.
  • Each of these targeted lymph nodes was examined also elastographically.
  • RESULTS: In total, 66 lymph nodes were examined; 37 lymph nodes revealed benign and 29 malignant tissue at the histologic evaluation.
  • Good elastographic records were obtained for all lymph nodes.
  • Of the 37 benign lymph nodes, 31 showed a homogeneous pattern of intermediate elasticity, whereas a dominance of hard tissue with variable patterns was found in 23 of 29 malignant lymph nodes.
  • Applying these criteria, the accuracy range among the three examiners was between 81.8 % and 87.9 % for benign lymph nodes and between 84.6 % and 86.4 % for malignant ones.
  • CONCLUSION: EUS elastography of mediastinal lymph nodes can be performed reliably.
  • The method might occasionally be useful for targeting the most suitable lymph nodes for FNAB.
  • [MeSH-major] Endosonography / methods. Lymph Nodes / ultrasonography. Lymphatic Metastasis / ultrasonography. Mediastinal Neoplasms / diagnosis
  • [MeSH-minor] Aged. Biopsy, Fine-Needle. Feasibility Studies. Female. Humans. Immunohistochemistry. Male. Middle Aged. Neoplasm Staging. Observer Variation. Probability. Sampling Studies. Sensitivity and Specificity

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  • (PMID = 18008203.001).
  • [ISSN] 1438-8812
  • [Journal-full-title] Endoscopy
  • [ISO-abbreviation] Endoscopy
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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7. Kim YK, Lee KS, Kim BT, Choi JY, Kim H, Kwon OJ, Shim YM, Yi CA, Kim HY, Chung MJ: Mediastinal nodal staging of nonsmall cell lung cancer using integrated 18F-FDG PET/CT in a tuberculosis-endemic country: diagnostic efficacy in 674 patients. Cancer; 2007 Mar 15;109(6):1068-77
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  • [Title] Mediastinal nodal staging of nonsmall cell lung cancer using integrated 18F-FDG PET/CT in a tuberculosis-endemic country: diagnostic efficacy in 674 patients.
  • BACKGROUND: Integrated (18)fluorine fluorodeoxyglucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) has shown somewhat variable sensitivity and specificity for mediastinal nodal staging in granulomatous disease endemic areas.
  • The purpose of the study was to prospectively evaluate the efficacy of PET/CT for mediastinal nodal staging in nonsmall cell lung cancer (NSCLC) patients in a tuberculosis-endemic country.
  • METHODS: Prospective assessment of the diagnostic efficacy of integrated PET/CT for detecting mediastinal nodal metastasis was performed in 674 patients (M:F ratio = 502:172; mean age, 61 years) with NSCLC.
  • Nodes showing greater (18)F-FDG uptake than mediastinum at PET without benign calcification or high attenuation >70 household unit (HU) at unenhanced CT were regarded as being positive for malignancy.
  • RESULTS: Of 2477 mediastinal nodal stations evaluated in 674 patients, 275 (11%) stations in 180 (27%) patients proved to be malignant.
  • On a per-person basis, the overall sensitivity, specificity, and accuracy of PET/CT for mediastinal nodal staging were 61% (110 of 180), 96% (473 of 494), and 86% (583 of 674), respectively.
  • CONCLUSIONS: Integrated PET/CT provides high specificity and reasonably high accuracy, but somewhat low sensitivity for mediastinal nodal staging of NSCLCs.
  • The high specificity is achieved at the expense of sensitivity by interpreting calcified nodes or nodes with high attenuation at CT, even with high FDG uptake at PET, as benign in a tuberculosis-endemic region.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Lymph Nodes / pathology. Lymphatic Metastasis. Male. Mediastinum / pathology. Middle Aged. Neoplasm Staging. Sensitivity and Specificity. Tuberculosis, Pulmonary / epidemiology

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  • (PMID = 17311309.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18
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8. Wang MZ, Wan XB, Chen Y, Zhang L, Zhong W, Zhong X, Shi JH, Liu T, Huang H, Zhang H, Xiao Y, Cai BQ, Li LY: [The results of transbronchial needle aspiration in 164 cases with enlarged mediastinal and/or hilar lymph nodes]. Zhonghua Nei Ke Za Zhi; 2009 Feb;48(2):133-5
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  • [Title] [The results of transbronchial needle aspiration in 164 cases with enlarged mediastinal and/or hilar lymph nodes].
  • OBJECTIVE: To evaluate the role of transbronchial needle aspiration (TBNA) in the diagnosis of patients with enlarged mediastinal and/or hilar lymph node.
  • METHODS: Patients with mediastinal and/or hilar lymphoadenopathy proven by CT scan were eligible for TBNA as reported.
  • RESULTS: From June 1 2004 to December 31 2007, 164 patients were examined: including 80 lung cancers, 69 lung benign diseases, 2 other malignancy tumor, and 13 without definite diagnosis.
  • Total 260 lymph nodes were punctured.
  • A total of 122 lymph nodes in the 80 lung cancer patients were aspirated by TBNA with a positive rate of 65.6% (80/122).
  • From June 1 2006 to December 31 2007, lymph node tissues able to make histology diagnosis were yield in 73.5% (64/87) patients.
  • CONCLUSION: TBNA is quite safe and helpful in diagnosis and staging of bronchogenic carcinoma, and in diagnosis of benign lung diseases.
  • [MeSH-major] Biopsy, Needle / methods. Lung Neoplasms / pathology. Lymph Nodes / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Female. Humans. Male. Mediastinum / pathology. Middle Aged. Neoplasm Staging. Young Adult

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  • (PMID = 19549469.001).
  • [ISSN] 0578-1426
  • [Journal-full-title] Zhonghua nei ke za zhi
  • [ISO-abbreviation] Zhonghua Nei Ke Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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9. Miletić Z, Gizdić B, Stoos-Veić T, Kaić G, Novak NP, Tadić M, Jaksić O, Ostović KT: Flow cytometric analysis of deep-seated lymph nodes. Coll Antropol; 2010 Jun;34(2):377-80
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  • [Title] Flow cytometric analysis of deep-seated lymph nodes.
  • Flow cytometry (FC) immunophenotyping is an important tool in the evaluation of lymphadenopathy and is widely used in the diagnosis of non-Hodgkin's lymphomas (NHLs) on fine-needle aspirates of lymph nodes and extranodal sites.
  • The aim of our study was to evaluate usefulness of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for FC analysis from deep-seated lymph nodes and to compare results of FC clonality analysis to cytomorphologic diagnosis of sampled lymph nodes.
  • Sixteen patients with suspected NHL of deep-seated lymph nodes obtained by EUS-FNA were submitted for FC clonality analysis using four-color multiparameter flow cytometry stained with kappa/lambda/CD19/CD45.
  • Monoclonality was demonstrated in seven of 11 cases cytologically diagnosed as NHL and four of 11 cases cytologically diagnosed as benign were polyclonal.
  • [MeSH-major] Flow Cytometry / methods. Lymph Nodes / pathology. Lymphoma, Non-Hodgkin / pathology
  • [MeSH-minor] Abdominal Neoplasms / pathology. Abdominal Neoplasms / ultrasonography. Adult. Aged. Aged, 80 and over. Biopsy, Fine-Needle / methods. Female. Humans. Immunoglobulin Light Chains / genetics. Male. Mediastinal Neoplasms / pathology. Mediastinal Neoplasms / ultrasonography. Middle Aged. Neoplasm Metastasis / pathology. Neoplasm Metastasis / ultrasonography. Pancreatic Neoplasms / pathology. Pancreatic Neoplasms / ultrasonography

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  • (PMID = 20698105.001).
  • [ISSN] 0350-6134
  • [Journal-full-title] Collegium antropologicum
  • [ISO-abbreviation] Coll Antropol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Croatia
  • [Chemical-registry-number] 0 / Immunoglobulin Light Chains
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10. Cerfolio RJ, Bryant AS: Ratio of the maximum standardized uptake value on FDG-PET of the mediastinal (N2) lymph nodes to the primary tumor may be a universal predictor of nodal malignancy in patients with nonsmall-cell lung cancer. Ann Thorac Surg; 2007 May;83(5):1826-9; discussion 1829-30
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  • [Title] Ratio of the maximum standardized uptake value on FDG-PET of the mediastinal (N2) lymph nodes to the primary tumor may be a universal predictor of nodal malignancy in patients with nonsmall-cell lung cancer.
  • BACKGROUND: The maximum standardized uptake value (maxSUV) on F-18 fluorodeoxyglucose-positron emission tomography (FDG-PET) scan of mediastinal (N2) lymph nodes may predict pathology in patients with nonsmall-cell lung cancer.
  • Thus, we evaluated the ratio of the maxSUV of the lymph node to the primary tumor at different centers to determine whether it was a universal predictor of lymph node malignancy.
  • Patients with nonsmall-cell lung cancer, a dedicated FDG-PET with the maxSUV of the primary lung tumor and FDG-avid mediastinal (N2) nodes reported (before therapy), and who underwent lymph node removal were eligible.
  • RESULTS: There were 239 patients with 335 FDG-PET-positive N2 nodes at 14 different PET centers.
  • The median ratio of the maxSUV of the lymph node to the maxSUV of the primary tumor of the pathologically proven malignant nodes was 0.58 (range, 0.32 to 1.61).
  • Benign nodes had a median ratio of 0.40 (range, 0.21 to 1.10, p = 0.02).
  • CONCLUSIONS: The ratio of the maxSUV of the mediastinal (N2) lymph node to the maxSUV of the primary tumor in patients with nonsmall-cell lung cancer predicts mediastinal nodal pathology across different PET centers.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Lymph Nodes / radionuclide imaging. Lymphatic Metastasis. Male. Mediastinum. Middle Aged. Neoplasm Staging. Predictive Value of Tests

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  • (PMID = 17462407.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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11. Riquet M, Bagan P, Fabre-Guillevin E, Scotté F, Cazes A, Le Pimpec-Barthes F: [Isolated malignant mediastinal lymphadenopathy]. Rev Pneumol Clin; 2010 Feb;66(1):36-40

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  • [Title] [Isolated malignant mediastinal lymphadenopathy].
  • Mediastinal adenopathies without pulmonary disease may be benign, lymphomatous or the metastases from intra- or extrathoracic malignancy or more rarely metastases with unknown primary site.
  • We observed 507 patients with isolated mediastinal adenopathies: benign, lymphomatous and metastatic disease represented 41.4% (210/507), 26.8% (136/507), 31.8% (161/507) of them, respectively.
  • Surgery was generally diagnostic, restricted to confirming the metastatic process, because of too numerous and disseminated or unresectable lymph nodes in 84% of patients (135/161).
  • However, radical surgery consisting in lymphadenectomy proved effective in case of mediastinal lymph node malignancy without other extra- and intrathoracic disease.
  • We suggest that including surgery in the multimodality treatment of mediastinal metastatic lymph nodes may be advisable in selected patients.
  • [MeSH-major] Lymphatic Metastasis / pathology. Mediastinal Neoplasms / pathology. Mediastinal Neoplasms / secondary
  • [MeSH-minor] Combined Modality Therapy. Diagnosis, Differential. Humans. Lymph Node Excision. Lymph Nodes / pathology. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / surgery. Neoplasm Staging. Patient Care Team. Prognosis

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  • [Copyright] Copyright (c) 2009 Elsevier Masson SAS. All rights reserved.
  • (PMID = 20207295.001).
  • [ISSN] 0761-8417
  • [Journal-full-title] Revue de pneumologie clinique
  • [ISO-abbreviation] Rev Pneumol Clin
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Number-of-references] 35
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12. Yeh DW, Lee KS, Han J, Yi CA, Lee HY, Chung MJ, Kim TS: Mediastinal nodes in patients with non-small cell lung cancer: MRI findings with PET/CT and pathologic correlation. AJR Am J Roentgenol; 2009 Sep;193(3):813-21
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  • [Title] Mediastinal nodes in patients with non-small cell lung cancer: MRI findings with PET/CT and pathologic correlation.
  • OBJECTIVE: The purpose of this article is to correlate MRI findings of mediastinal nodes with PET/CT and pathology in non-small cell lung cancer.
  • CONCLUSION: Malignant nodes show high FDG uptake at PET, or eccentric cortical thickening or obliterated fatty hilum on T2-weighted MRI.
  • Benign nodes (with follicular hyperplasia, sinus histiocytosis, fibrotic micronodules, or calcification) may show high FDG uptake at PET, whereas MRI may help distinguish benign from malignant nodes by showing low signal intensity in nodes on T2-weighted MRI.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Contrast Media. Humans. Lymph Nodes / pathology. Lymph Nodes / radiography. Lymph Nodes / radionuclide imaging. Male. Mediastinum. Middle Aged. Neoplasm Staging. Sensitivity and Specificity


13. Eloubeidi MA, Cerfolio RJ, Chen VK, Desmond R, Syed S, Ojha B: Endoscopic ultrasound-guided fine needle aspiration of mediastinal lymph node in patients with suspected lung cancer after positron emission tomography and computed tomography scans. Ann Thorac Surg; 2005 Jan;79(1):263-8
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  • [Title] Endoscopic ultrasound-guided fine needle aspiration of mediastinal lymph node in patients with suspected lung cancer after positron emission tomography and computed tomography scans.
  • Positron emission and computed tomography (CT) scans can identify suspicious lymph nodes that require biopsy.
  • We prospectively evaluated the yield and accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in sampling mediastinal lymph nodes and compared its accuracy to that of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and CT in staging NSCLC.
  • METHODS: A consecutive series of patients with suspicious nodes on PET or CT scan in the posterior mediastinal lymph node stations (#5, 7, 8, or 9) were prospectively evaluated by EUS-FNA.
  • The reference standard included thoracotomy with complete lymphadenectomy in patients with lung cancer or if EUS-FNA was benign, repeat clinical imaging, or long-term follow-up.
  • RESULTS: There were 104 patients (63 men) with 125 lesions (117 lymph nodes, 8 left adrenal glands) who underwent EUS-FNA.
  • EUS-FNA was more accurate and had a higher positive predictive value than the PET or CT (p < 0.001) scan in confirming cancer in the posterior mediastinal lymph nodes.
  • It is more accurate and has a higher predictive value than either the PET scan or CT scan for posterior mediastinal lymph nodes.
  • [MeSH-major] Biopsy, Fine-Needle. Carcinoma, Non-Small-Cell Lung / secondary. Esophagoscopy. Lung Neoplasms / pathology. Lymphatic Diseases / pathology. Lymphatic Metastasis / pathology. Neoplasm Staging / methods. Positron-Emission Tomography. Tomography, X-Ray Computed. Ultrasonography, Interventional

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  • (PMID = 15620955.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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14. Lee JW, Kim BS, Lee DS, Chung JK, Lee MC, Kim S, Kang WJ: 18F-FDG PET/CT in mediastinal lymph node staging of non-small-cell lung cancer in a tuberculosis-endemic country: consideration of lymph node calcification and distribution pattern to improve specificity. Eur J Nucl Med Mol Imaging; 2009 Nov;36(11):1794-802
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  • [Title] 18F-FDG PET/CT in mediastinal lymph node staging of non-small-cell lung cancer in a tuberculosis-endemic country: consideration of lymph node calcification and distribution pattern to improve specificity.
  • PURPOSE: The aim of the study was to assess the accuracy of (18)F-fluorodeoxyglucose (FDG) PET/CT in mediastinal lymph node staging of patients with non-small-cell lung cancer (NSCLC) in a region with a high prevalence of granulomatous disease.
  • Mediastinal node staging was determined using the American Joint Committee on Cancer (AJCC) staging system.
  • RESULTS: A total of 182 patients with 778 mediastinal node stations were evaluated.
  • After lymph nodes with calcification and bilateral hilar distribution were considered benign, sensitivity and specificity of PET/CT were 75% and 89% on a per-patient basis and 66% and 96% on a per-node station basis.
  • CONCLUSION: This prospective study suggests that FDG PET/CT can more accurately stage mediastinal lymph nodes than CT.
  • Considering lymph node calcification and distribution pattern could improve specificity at the cost of a decrease in sensitivity.
  • [MeSH-major] Calcinosis. Carcinoma, Non-Small-Cell Lung / pathology. Fluorodeoxyglucose F18. Lung Neoplasms / pathology. Lymph Nodes / pathology. Mediastinum. Tuberculosis / complications
  • [MeSH-minor] Contrast Media. Endemic Diseases. False Positive Reactions. Female. Humans. Male. Middle Aged. Neoplasm Staging. Positron-Emission Tomography. Radiography, Thoracic. Sensitivity and Specificity. Tomography, X-Ray Computed

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  • (PMID = 19430783.001).
  • [ISSN] 1619-7089
  • [Journal-full-title] European journal of nuclear medicine and molecular imaging
  • [ISO-abbreviation] Eur. J. Nucl. Med. Mol. Imaging
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Contrast Media; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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15. Tian Q, Chen LA, Wang HS, Zhu BH, Tian L, Yang Z, An Y: Endobronchial ultrasound-guided transbronchial needle aspiration of undiagnosed mediastinal lymphadenopathy. Chin Med J (Engl); 2010 Aug;123(16):2211-4
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  • [Title] Endobronchial ultrasound-guided transbronchial needle aspiration of undiagnosed mediastinal lymphadenopathy.
  • BACKGROUND: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can sample the enlarged mediastinal lymph nodes which are unreachable by conventional bronchoscopy.
  • METHODS: From July 2009 to December 2009, 52 patients with undiagnosed enlarged mediastinal lymph nodes were accessed with EBUS-TBNA in the People's Liberation Army General Hospital.
  • Among the 16 sarcoidosis patients, who were diagnosed by a combination of the clinical and radiological information as well as pathological results obtained by EBUS-TBNA, nine of them had granulomas and benign lymphoid cells detected by EBUS-TBNA.
  • CONCLUSIONS: EBUS-TBNA can provide a safe and effective method to sample mediastinal leisions suspected of malignancy.
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Bronchi / pathology. Bronchi / ultrasonography. Female. Humans. Male. Middle Aged. Neoplasm Staging / methods. Young Adult

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  • (PMID = 20819667.001).
  • [ISSN] 0366-6999
  • [Journal-full-title] Chinese medical journal
  • [ISO-abbreviation] Chin. Med. J.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] China
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16. Benlloch S, Galbis-Caravajal JM, Alenda C, Peiró FM, Sanchez-Ronco M, Rodríguez-Paniagua JM, Baschwitz B, Rojas E, Massutí B: Expression of molecular markers in mediastinal nodes from resected stage I non-small-cell lung cancer (NSCLC): prognostic impact and potential role as markers of occult micrometastases. Ann Oncol; 2009 Jan;20(1):91-7
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  • [Title] Expression of molecular markers in mediastinal nodes from resected stage I non-small-cell lung cancer (NSCLC): prognostic impact and potential role as markers of occult micrometastases.
  • BACKGROUND: Occult lymph node (LN) metastases are clinically relevant and confer a worse prognosis in non-small-cell lung cancer (NSCLC) patients.
  • Only CEACAM5 and PLUNC showed high expression in lung tumor tissue and null expression in RNA from benign LNs.
  • Eight of 38 NSCLC patients had positive expression in pN2 nodes by CEACAM5 and/or PLUNC and disease-free survival (P=0.028) and overall survival time was significantly worse in these patients compared with those with negative expression (P=0.0083).

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  • (PMID = 18664559.001).
  • [ISSN] 1569-8041
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Validation Studies
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / RNA, Messenger
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17. Zhang L, Cheng GY, Lü N, Mao YS, Zhang ZH, Li J, Li XY, Ni XG, Lai SQ, He S, Yu GX, Ju FH, Xun HY, Cheng RR, Xu PP, Wang GQ: [Value of endobronchial ultrasound-guided transbronchial needle aspiration in hilar and mediastinal lesions]. Zhonghua Yi Xue Za Zhi; 2010 Apr 27;90(16):1109-12
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  • [Title] [Value of endobronchial ultrasound-guided transbronchial needle aspiration in hilar and mediastinal lesions].
  • METHODS: A total of 89 patients with intrathoracic lesions underwent EBUS-TBNA, including 56 pulmonary lesions, 7 lymph node staging in lung cancer patients, 21 unknown hilar and/or mediastinal lymphadenopathies and 5 mediastinal tumors.
  • In 56 patients with pulmonary lesions, EBUS-TBNA demonstrated 45 malignant tumors, 5 benign diseases, 3 suspicious cancers, 1 negative and 2 unsatisfied samples.
  • In 21 cases with mediastinal and/or hilar lymphadenopathy, EBUS-TBNA demonstrated 3 malignant tumors, 13 benign diseases, 2 negative and 3 unsatisfied samples.
  • All 5 mediastinal lesions were malignant.
  • Three negative cases were diagnosed as benign by clinical follow-ups.
  • [MeSH-minor] Adult. Aged. Bronchoscopy. Female. Humans. Lung Diseases / diagnosis. Lymph Nodes / pathology. Male. Mediastinal Neoplasms / diagnosis. Middle Aged. Neoplasm Staging

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  • (PMID = 20646428.001).
  • [ISSN] 0376-2491
  • [Journal-full-title] Zhonghua yi xue za zhi
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Evaluation Studies; Journal Article
  • [Publication-country] China
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18. Ozawa Y, Hara M, Sakurai K, Nakagawa M, Tamaki T, Nishio M, Shibamoto Y: Diagnostic accuracy of (18)F-2-deoxy-fluoro-D-glucose positron emission tomography for pN2 lymph nodes in patients with lung cancer. Acta Radiol; 2010 Mar;51(2):150-5
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  • [Title] Diagnostic accuracy of (18)F-2-deoxy-fluoro-D-glucose positron emission tomography for pN2 lymph nodes in patients with lung cancer.
  • PURPOSE: To evaluate the accuracy of FDG-PET for diagnosing nodal status in lung cancer patients with pathologically proven N2 lymph nodes and compare it with that of computed tomography (CT).
  • Lymph nodes were considered to be positive when uptake higher than the surrounding mediastinal level was visually observed.
  • Slight symmetrical mediastinal uptake was considered to be negative, representing benign physiological accumulation.
  • Radiological and pathological correlation was investigated, and the association between FDG accumulation and the size of metastatic lymph nodes and metastatic lesions was evaluated.
  • The maximum area of metastatic foci was 15.8 +/-21.3 mm(2) (mean +/- SD) in false-negative nodes and 75.0+/-56.3 mm(2) in true-positive nodes (P<0.0001).
  • [MeSH-major] Fluorodeoxyglucose F18. Lung Neoplasms / pathology. Lymph Nodes / radionuclide imaging. Lymphatic Metastasis / radionuclide imaging. Positron-Emission Tomography / methods. Radiopharmaceuticals
  • [MeSH-minor] Aged. Diagnosis, Differential. False Negative Reactions. False Positive Reactions. Female. Humans. Male. Middle Aged. Neoplasm Staging. Radiographic Image Interpretation, Computer-Assisted. Tomography, X-Ray Computed

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  • (PMID = 20092375.001).
  • [ISSN] 1600-0455
  • [Journal-full-title] Acta radiologica (Stockholm, Sweden : 1987)
  • [ISO-abbreviation] Acta Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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19. Vincent BD, El-Bayoumi E, Hoffman B, Doelken P, DeRosimo J, Reed C, Silvestri GA: Real-time endobronchial ultrasound-guided transbronchial lymph node aspiration. Ann Thorac Surg; 2008 Jan;85(1):224-30
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  • [Title] Real-time endobronchial ultrasound-guided transbronchial lymph node aspiration.
  • The gold standard for mediastinal staging has been mediastinoscopy.
  • Here we report the use of EBUS-TBNA as a diagnostic modality for mediastinal adenopathy and staging modality for lung cancer.
  • Of the 152 patients, 117 were included in the final statistical analysis after excluding those with benign disease diagnosed by EBUS-TBNA.
  • Four patients had benign diagnoses at surgical pathology.
  • Only 1 surgical patient was found to have nodal metastasis at a lymph node station previously biopsied by EBUS-TBNA (negative predictive value, 97%).
  • CONCLUSIONS: EBUS-TBNA is useful in accessing mediastinal and hilar lymph nodes for the diagnosis and staging of non-small cell lung cancer and other disorders of the mediastinum.
  • [MeSH-major] Biopsy, Fine-Needle / methods. Bronchoscopes. Endosonography / methods. Lung Neoplasms / pathology. Lymph Nodes / pathology. Lymph Nodes / ultrasonography
  • [MeSH-minor] Academic Medical Centers. Adult. Aged. Equipment Design. Female. Humans. Male. Mediastinal Neoplasms / pathology. Mediastinal Neoplasms / surgery. Middle Aged. Neoplasm Staging. Predictive Value of Tests. Preoperative Care. Prognosis. Retrospective Studies. Risk Assessment. Sensitivity and Specificity

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  • (PMID = 18154815.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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20. Nakagawa M, Hara M, Sakurai K, Ozawa Y, Mizuno A, Tamaki T, Nishio M, Shibamoto Y: Diagnostic accuracy of 18F-2-deoxy-fluoro-D-glucose positron emission tomography for pN1 lymph nodes in patients with lung cancer. Acta Radiol; 2009 Jul;50(6):638-44
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  • [Title] Diagnostic accuracy of 18F-2-deoxy-fluoro-D-glucose positron emission tomography for pN1 lymph nodes in patients with lung cancer.
  • PURPOSE: To evaluate the accuracy of (18)F-2-deoxy-fluoro-D-glucose (FDG) positron emission tomography (PET) for diagnosing nodal status in lung cancer patients with pathologically proven N1 (pN1) lymph node metastases, in comparison with that of computed tomography (CT).
  • Lymph nodes were considered to be positive when uptake higher than the surrounding mediastinum level was visually observed.
  • Radiological and pathological correlation was investigated, and the association between FDG uptake and the size of metastatic nodes was evaluated.
  • FDG-PET could not depict pN1 lymph node in six (32%) of 19 patients.
  • In two patients (11%), mild symmetrical hilar and mediastinal accumulation was found and considered as benign physiological uptake.
  • In six patients (32%), the ipsilateral mediastinal uptake was depicted and diagnosed as cN2.
  • [MeSH-major] Carcinoma / diagnosis. Fluorodeoxyglucose F18. Lung Neoplasms / radionuclide imaging. Lymph Nodes / radionuclide imaging. Lymphoma / radionuclide imaging. Positron-Emission Tomography / methods. Radiopharmaceuticals
  • [MeSH-minor] Aged. Aged, 80 and over. Diagnosis, Differential. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Reproducibility of Results. Tomography, X-Ray Computed / methods

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  • (PMID = 19492198.001).
  • [ISSN] 1600-0455
  • [Journal-full-title] Acta radiologica (Stockholm, Sweden : 1987)
  • [ISO-abbreviation] Acta Radiol
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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21. Vilmann P, Krasnik M, Larsen SS, Jacobsen GK, Clementsen P: Transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy: a combined approach in the evaluation of mediastinal lesions. Endoscopy; 2005 Sep;37(9):833-9
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  • [Title] Transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) biopsy: a combined approach in the evaluation of mediastinal lesions.
  • BACKGROUND AND STUDY AIMS: It would be desirable to develop minimally invasive methods of tissue diagnosis from lymph nodes as well as solid lesions in the mediastinum.
  • The aim of the present study was to test the combined method of transesophageal endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the evaluation of mediastinal lesions.
  • PATIENTS AND METHODS: EUS-FNA and EBUS-TBNA were compared in 33 patients, for the staging of lung cancer in patients with an established diagnosis of non-small-cell lung cancer (n = 20) or for diagnosis of a suspicious mediastinal lesion in patients with suspected lung cancer (n = 13).
  • EUS-FNA and EBUS-TBNA demonstrated cancer in 26 and 28 lesions, respectively, and benign cytology in 30 and 28 lesions, respectively.
  • Conversely, EUS-FNA diagnosed 12 additional cancer diagnoses, one suspicious and one specific benign diagnosis (sarcoidosis) in addition to EBUS-TBNA.
  • With a combined approach (EUS-FNA + EBUS-TBNA) in 28 of the 31 patients in whom a final diagnosis was obtained in the evaluation of mediastinal cancer, 20 patients were found to have mediastinal involvement, whereas no mediastinal metastases were found in eight patients.
  • The accuracy of EUS-FNA and EBUS-TBNA, in combination, for the diagnosis of mediastinal cancer was 100 % (95 % CI, 83 - 100 %).
  • A combined approach with both EUS-FNA and EBUS-TBNA may be able to replace more invasive methods for evaluating lung cancer patients with suspected hilar or mediastinal metastases, as well as for evaluating unclear mediastinal or hilar lesions.
  • [MeSH-major] Biopsy, Fine-Needle / methods. Carcinoma, Non-Small-Cell Lung / pathology. Endosonography. Lung Neoplasms / pathology. Mediastinal Neoplasms / pathology. Mediastinal Neoplasms / secondary
  • [MeSH-minor] Adult. Aged. Bronchi. Esophagus. Female. Humans. Male. Middle Aged. Neoplasm Staging / methods

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  • (PMID = 16116534.001).
  • [ISSN] 0013-726X
  • [Journal-full-title] Endoscopy
  • [ISO-abbreviation] Endoscopy
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Germany
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22. Beyer F, Buerke B, Gerss J, Scheffe K, Puesken M, Weckesser M, Schober O, Heindel W, Wessling J: Prediction of lymph node metastases in NSCLC. Three dimensional anatomical parameters do not substitute FDG-PET-CT. Nuklearmedizin; 2010;49(1):41-8; quiz N1

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prediction of lymph node metastases in NSCLC. Three dimensional anatomical parameters do not substitute FDG-PET-CT.
  • PURPOSE: To distinguish between benign and malignant mediastinal lymph nodes in patients with NSCLC by comparing 2D and semi-automated 3D measurements in FDG-PET-CT.
  • 299 mediastinal lymph-nodes were evaluated independently by two radiologists, both manually and by semi-automatic segmentation software.
  • RESULTS: The standard of reference revealed involvement in 87 (29%) of 299 lymph nodes.
  • CONCLUSION: Optimized semi-automated three dimensional parameters by CT cannot approximate reported data on FDG-PET-CT for lymph node assessment in NSCLC.
  • [MeSH-minor] Aged. Automation. Humans. Lung Neoplasms / pathology. Lung Neoplasms / radiography. Lung Neoplasms / radionuclide imaging. Lymph Nodes / pathology. Lymph Nodes / radiography. Lymph Nodes / radionuclide imaging. Middle Aged. Neoplasm Staging. Positron-Emission Tomography. Predictive Value of Tests. ROC Curve. Retrospective Studies. Sensitivity and Specificity

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  • (PMID = 20087533.001).
  • [ISSN] 0029-5566
  • [Journal-full-title] Nuklearmedizin. Nuclear medicine
  • [ISO-abbreviation] Nuklearmedizin
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18
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23. Storch I, Shah M, Thurer R, Donna E, Ribeiro A: Endoscopic ultrasound-guided fine-needle aspiration and Trucut biopsy in thoracic lesions: when tissue is the issue. Surg Endosc; 2008 Jan;22(1):86-90
ClinicalTrials.gov. clinical trials - ClinicalTrials.gov .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: Endoscopic ultrasound-guided fine-needle aspiration (EUS FNA) has a high accuracy in the evaluation of mediastinal lesions.
  • The lesions sampled included 41 lymph nodes (six aorto-pulmonary window, 32 subcarinal, two right paratracheal, one paraesophageal ATS station 8), five lung masses, and two esophageal masses.
  • Twenty-nine patients had malignant disease and 19 had benign disorders.
  • EUS TCB was better than FNA for benign diseases (89% vs. 63%, p = 0.04).
  • EUS-guided TCB should be considered in patients with benign disorders of the mediastinum when other modalities fail to yield a diagnosis.
  • [MeSH-major] Biopsy, Fine-Needle / methods. Endosonography / methods. Mediastinal Neoplasms / diagnostic imaging. Mediastinal Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Cohort Studies. Female. Humans. Immunohistochemistry. Lymph Nodes / diagnostic imaging. Lymph Nodes / pathology. Male. Mediastinal Diseases / diagnostic imaging. Mediastinal Diseases / pathology. Middle Aged. Neoplasm Invasiveness / diagnostic imaging. Neoplasm Invasiveness / pathology. Probability. Retrospective Studies. Risk Assessment. Sensitivity and Specificity

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  • [Cites] Gastrointest Endosc. 2002 Oct;56(4 Suppl):S18-21 [12297743.001]
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  • (PMID = 17479313.001).
  • [ISSN] 1432-2218
  • [Journal-full-title] Surgical endoscopy
  • [ISO-abbreviation] Surg Endosc
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] Germany
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24. Cerfolio RJ, Bryant AS: Survival of patients with true pathologic stage I non-small cell lung cancer. Ann Thorac Surg; 2009 Sep;88(3):917-22; discussion 922-3
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Of the 721 (c)stage I, 405 (56%) had (p)stage I disease; 101 (14%) were clinically over-staged (benign nodules).
  • About 32% of patients are under-staged (most commonly from nonimaged N2 disease) despite the liberal application of all of the techniques that assess mediastinal lymph nodes preoperatively.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Algorithms. Biopsy. Disease-Free Survival. Female. Humans. Image Processing, Computer-Assisted. Lung / pathology. Lymph Node Excision. Lymph Nodes / pathology. Male. Middle Aged. Neoplasm Staging. Pneumonectomy. Positron-Emission Tomography. Predictive Value of Tests. Prognosis. Retrospective Studies. Tomography, X-Ray Computed. Young Adult

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  • (PMID = 19699920.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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25. Medford AR, Bennett JA, Free CM, Agrawal S: Endobronchial ultrasound guided transbronchial needle aspiration. Postgrad Med J; 2010 Feb;86(1012):106-15
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Staging for non-small cell lung cancer (NSCLC) requires accurate assessment of the mediastinal lymph nodes which determines treatment and outcome.
  • As radiological staging is limited by its specificity and sensitivity, it is necessary to sample the mediastinal nodes.
  • Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) offers a minimally invasive alternative to mediastinoscopy with additional access to the hilar nodes, a better safety profile, and it removes the costs and hazards of theatre time and general anaesthesia with comparable sensitivity, although the negative predictive value of mediastinoscopy (and sample size) is greater.
  • It can also have predictive value both in sonographic appearance of the nodes and histological characteristics.
  • EBUS-TBNA is therefore indicated for NSCLC staging, diagnosis of lung cancer when there is no endobronchial lesion, and diagnosis of both benign (especially tuberculosis and sarcoidosis) and malignant mediastinal lesions.
  • [MeSH-minor] Clinical Competence / standards. Costs and Cost Analysis. Education, Medical, Continuing. Equipment Design. Forecasting. Humans. Lymphatic Metastasis. Mediastinal Neoplasms / pathology. Neoplasm Staging. Specimen Handling. Ultrasonography, Interventional / economics. Ultrasonography, Interventional / methods

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  • (PMID = 20145060.001).
  • [ISSN] 1469-0756
  • [Journal-full-title] Postgraduate medical journal
  • [ISO-abbreviation] Postgrad Med J
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 71
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26. Xu HF, Liu Y, Zhang JH, Zhou RS, Zhou FH, Yuan MH: [The application of 18F-fluorodeoxyglucose positron emission tomography in the diagnosis and staging of lung cancer]. Zhonghua Jie He He Hu Xi Za Zhi; 2005 Feb;28(2):108-11
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  • Focuses with a SUV > 2.5 were judged as malignant changes, while SUV < or = 2.5 was judged as benign.
  • (1) 58 cases were confirmed to be malignant by surgery or pathological examination, while 36 cases were proved benign by pathology or empirical therapy. (2) The sensitivity, specificity, accuracy, positive and negative predictive values were 69%, 65%, 68%, 82% and 49% respectively for CT; and 91%, 89%, 90%, 93% and 87% respectively for SUV analysis; and 95%, 94%, 95%, 97% and 92% respectively for visual plus SUV methods. (3) Among 34 patients with mediastinal lymph node involvement confirmed by pathology, 18F-FDG PET detected 30 cases, while CT detected only 18 cases (P < 0.01). (4) 18F-FDG PET revealed 19 cases with distant metastases, while CT only discovered 8 cases with distant metastases.
  • [MeSH-major] Fluorodeoxyglucose F18. Lung Neoplasms / pathology. Lung Neoplasms / radionuclide imaging. Lymph Nodes / pathology. Positron-Emission Tomography. Radiopharmaceuticals
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Diagnosis, Differential. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Predictive Value of Tests. Reproducibility of Results. Sensitivity and Specificity. Tomography, X-Ray Computed

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  • (PMID = 15854393.001).
  • [ISSN] 1001-0939
  • [Journal-full-title] Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases
  • [ISO-abbreviation] Zhonghua Jie He He Hu Xi Za Zhi
  • [Language] chi
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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27. Feller-Kopman D, Lunn W, Ernst A: Autofluorescence bronchoscopy and endobronchial ultrasound: a practical review. Ann Thorac Surg; 2005 Dec;80(6):2395-401
ClinicalTrials.gov. clinical trials - ClinicalTrials.gov .

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  • The EBUS can accurately define airway invasion versus compression from tumors, guide transbronchial needle aspiration of hilar and mediastinal lymph nodes, and predict, based on ultrasound morphology, whether peripheral nodules are benign or malignant.
  • [MeSH-minor] Fluorescence. Humans. Neoplasm Invasiveness

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  • (PMID = 16305928.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Number-of-references] 41
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28. Santini M, Fiorello A, Mansi L, Rambaldi PF, Vicidomini G, Busiello L, Messina G, Nargi P: The role of technetium-99m hexakis-2-methoxyisobutyl isonitrile in the detection of neoplastic lung lesions. Eur J Cardiothorac Surg; 2009 Feb;35(2):325-31
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  • Nineteen patients had a benign disease.
  • The mean size+/-standard deviation of benign nodules was 3.3+/-1.71 cm (range 2-6 cm). (99m)Tc-MIBI SPECT delineated focal lesions with an increase in tracer accumulation in 55/60 malignant lesions; in 5/60 malignant lesions was negative.
  • In patients with neoplastic lesion, the mean T/N ratio value+/-standard deviation was 1.72+/-0.35 whereas in patients with benign lesions was 1.14+/-0.25.
  • Metastatic mediastinal lymph nodes were found in 3/57 patients. (99m)Tc-MIBI SPECT showed a specificity and PPV of 100% in the detection of mediastinal lymph nodes with sensitivity, and PNV of 66% and 97%, respectively.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Epidemiologic Methods. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Tomography, Emission-Computed, Single-Photon / methods. Tomography, X-Ray Computed

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  • (PMID = 18996706.001).
  • [ISSN] 1873-734X
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 971Z4W1S09 / Technetium Tc 99m Sestamibi
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29. Hofman MS, Smeeton NC, Rankin SC, Nunan T, O'Doherty MJ: Observer variation in FDG PET-CT for staging of non-small-cell lung carcinoma. Eur J Nucl Med Mol Imaging; 2009 Feb;36(2):194-9
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  • Individual mediastinal lymph node stations were assessed as benign/inflammatory, equivocal or malignant, and AJCC N and M stage were also assigned.
  • Agreement for inferior and superior mediastinal nodes (stations 1, 2, 3, 7, 8, 9) was either almost perfect or substantial (kappa(w) = 0.71-0.88), but lower for hilar nodes (10; kappa(w) = 0.56-0.71).
  • Interreporter variability was greatest for aortopulmonary nodes (5, 6; kappa(w) = 0.48-0.55).
  • CONCLUSION: Amongst experienced reporters in a single centre, there was a very high level of agreement for both mediastinal nodal stage and detection of distant metastases with PET-CT.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / diagnosis. Carcinoma, Non-Small-Cell Lung / pathology. Fluorodeoxyglucose F18. Neoplasm Staging / methods. Positron-Emission Tomography / statistics & numerical data. Tomography, X-Ray Computed / statistics & numerical data
  • [MeSH-minor] Humans. Neoplasm Metastasis. Observer Variation. Referral and Consultation

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  • (PMID = 18828012.001).
  • [ISSN] 1619-7089
  • [Journal-full-title] European journal of nuclear medicine and molecular imaging
  • [ISO-abbreviation] Eur. J. Nucl. Med. Mol. Imaging
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18
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30. Koh MS, Tee A, Wong P, Antippa P, Irving LB: Advances in lung cancer diagnosis and staging: endobronchial ultrasound. Intern Med J; 2008 Feb;38(2):85-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: Endobronchial ultrasound (EBUS) is an accurate and relatively less invasive procedure for the diagnosis of lung lesions and mediastinal lymph node staging for lung cancer.
  • METHODS: Consecutive patients who underwent EBUS-transbronchial lung biopsy (EBUS-TBLB) for biopsy of peripheral pulmonary lesions or for transbronchial needle aspiration (TBNA) of mediastinal lymph node enlargement were included in this audit.
  • Malignancy was diagnosed in 14 cases and a benign aetiology in four.
  • The yield from EBUS-TBNA was 88% and the average size of the lymph nodes was 2.3 cm.
  • The lymph nodes were all located in the subcarinal station except for two that were in the lower paratracheal station.
  • Malignancy was diagnosed in 10 cases on TBNA and 4 cases had benign pathology.
  • [MeSH-major] Bronchi / pathology. Endosonography. Lung Neoplasms / pathology. Lung Neoplasms / ultrasonography. Lymph Nodes / pathology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biopsy, Fine-Needle. Female. Humans. Male. Middle Aged. Neoplasm Staging. Sensitivity and Specificity

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  • [CommentIn] Intern Med J. 2008 Feb;38(2):75-6 [18290825.001]
  • (PMID = 17916175.001).
  • [ISSN] 1445-5994
  • [Journal-full-title] Internal medicine journal
  • [ISO-abbreviation] Intern Med J
  • [Language] eng
  • [Publication-type] Comparative Study; Evaluation Studies; Journal Article
  • [Publication-country] Australia
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31. Li C, Liu ZS, Du XM, He L, Chen J, Wang W, Sun F, Du F, Luo ZG, Xue ZL, Zhao Y, Zhou CW: Clinical value of whole-body magnetic resonance diffusion weighted imaging on detection of malignant metastases. Chin Med Sci J; 2009 Jun;24(2):112-6

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • For the assessment of the diagnostic capability of WB-DWI, WB-DWI were compared with CT for demonstrating mediastinal lymph node metastases and lung metastases, and with conventional MRI for demonstrating metastases in other locations.
  • RESULTS: WB-DWI demonstrated 143 focuses, 14 of which were diagnosed to be benign lesions in routine imaging.
  • The number of bone metastases depicted on WB-DWI and routine imaging was 85 and 86; lymph node metastases was 17 and 18; liver metastases was 14 and 14; lung metastases was 4 and 8; and brain metastases was 6 and 8, respectively.
  • WB-DWI failed to detect 12 metastatic lesions including 3 osteoplastic bone metastases, 4 lung metastases, 3 mediastinal lymph node metastases, and 2 brain metastases.
  • Four metastatic lesions including 2 deltopectoral lymph nodes and 2 rib metastases were detected with WB-DWI alone, all of which evolved greatly during clinical follow-up for more than 6 months.
  • WB-DWI had higher detection rates for metastatic lesions in liver, bone, and lymph nodes than those in lung and brain (chi2=30, P<0.001).
  • The limitations of WB-DWI might be had high false-positive rate and low efficiency in detecting mediastinal lymph node, brain, and lung metastases.

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  • (PMID = 19618609.001).
  • [ISSN] 1001-9294
  • [Journal-full-title] Chinese medical sciences journal = Chung-kuo i hsueh k'o hsueh tsa chih
  • [ISO-abbreviation] Chin. Med. Sci. J.
  • [Language] ENG
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] China
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32. Chen G, Liu XY, Wang Z, Liu FY: Vascular endothelial growth factor C: the predicator of early recurrence in patients with N2 non-small-cell lung cancer. Eur J Cardiothorac Surg; 2010 Mar;37(3):546-51
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  • OBJECTIVE: Mediastinal lymph node metastasis (N2) is a key prognostic factor for lung carcinoma.
  • METHODS: Cancer tissue samples from 92 patients with pN2 non-small-cell lung cancer and benign lung disease tissues samples from 30 patients were examined by reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry assays to detect VEGF-C expression.
  • RESULTS: VEGF-C mRNA expression was observed in 64 (70%) pN2 lung cancer tissues, but was not found in benign lung disease tissues.
  • About one-half of the patients with N2 non-small-cell lung cancer would develop recurrence disease within 1 year after surgery, frequently with mediastinal nodes, brain or lung metastases.
  • [MeSH-minor] Adult. Aged. Brain Neoplasms / secondary. Chemotherapy, Adjuvant. Epidemiologic Methods. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Recurrence, Local. Prognosis. RNA, Messenger / genetics. RNA, Neoplasm / genetics. Radiotherapy, Adjuvant. Reverse Transcriptase Polymerase Chain Reaction / methods

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  • [Copyright] Copyright (c) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
  • (PMID = 19758816.001).
  • [ISSN] 1873-734X
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / RNA, Messenger; 0 / RNA, Neoplasm; 0 / VEGFC protein, human; 0 / Vascular Endothelial Growth Factor C
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33. Hindié E, Zanotti-Fregonara P, Duron F, Keller I, Bouchard P, Devaux JY: Should 'low-risk' thyroid cancer patients with residual thyroglobulin be re-treated with iodine 131? Clin Endocrinol (Oxf); 2007 Mar;66(3):329-34
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  • Four patients had isolated (131)I uptake in the mediastinal region.
  • No abnormalities were found on complementary mediastinal imaging.
  • This finding was interpreted as benign (131)I thymic uptake.
  • The last three patients also had mediastinal thymic uptake associated with a slight thyroid bed uptake.
  • One patient had a gradual increase in the thyroglobulin level, and underwent resection of nonfunctioning neck lymph nodes.
  • The authors also briefly discuss the hypothesis that enhanced thymus might be a source of benign thyroglobulin secretion.
  • [MeSH-minor] Adult. Biomarkers / blood. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Iodine Radioisotopes / therapeutic use. Lymphatic Metastasis. Male. Middle Aged. Neck Dissection. Neoplasm Staging. Prospective Studies. Radiopharmaceuticals / therapeutic use. Retreatment. Risk Assessment / methods. Thymus Gland / radionuclide imaging. Thymus Gland / secretion. Thyroidectomy. Whole-Body Counting

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  • (PMID = 17302864.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Iodine Radioisotopes; 0 / Radiopharmaceuticals; 9010-34-8 / Thyroglobulin
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34. Solli P, Spaggiari L: Indications and developments of video-assisted thoracic surgery in the treatment of lung cancer. Oncologist; 2007 Oct;12(10):1205-14
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  • The VATS approach is presently used in many intrathoracic disorders, but while well established in benign chest disease, its role continues to evolve regarding the management of lung cancer.
  • It is currently considered for the evaluation and treatment of suspected (or known) pleural effusion and in the diagnosis of indeterminate pulmonary nodules, and it has a complementary role to standard cervical mediastinoscopy in the invasive staging of mediastinal lymph nodes.
  • [MeSH-minor] Humans. Minimally Invasive Surgical Procedures. Neoplasm Staging. Patient Care Planning. Prognosis

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  • (PMID = 17962614.001).
  • [ISSN] 1083-7159
  • [Journal-full-title] The oncologist
  • [ISO-abbreviation] Oncologist
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 105
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35. Unroe MA, Shofer SL, Wahidi MM: Training for endobronchial ultrasound: methods for proper training in new bronchoscopic techniques. Curr Opin Pulm Med; 2010 Jul;16(4):295-300
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE OF REVIEW: The field of pulmonary medicine has experienced a rapid growth in innovative new technologies aimed at both diagnosis and treatment of airway, mediastinal and parenchymal disorders.
  • Endobronchial ultrasound (EBUS) has emerged as an extremely useful tool in real-time guidance of transbronchial needle aspiration (TBNA) of mediastinal and hilar structures.
  • A growing body of evidence has demonstrated the efficacy of EBUS-TBNA in the diagnosis and staging of lung cancer, as well as the diagnosis of benign causes of mediastinal and hilar lymphadenopathy.
  • [MeSH-minor] Biopsy, Needle / standards. Clinical Competence. Computer Simulation. Evidence-Based Medicine. Humans. Lymph Nodes / pathology. Neoplasm Staging. Teaching / methods

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  • (PMID = 20531196.001).
  • [ISSN] 1531-6971
  • [Journal-full-title] Current opinion in pulmonary medicine
  • [ISO-abbreviation] Curr Opin Pulm Med
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 26
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36. Mao YS, He J, Zheng R, Lin L, Liu L, Cheng Z: [The role of (18)F-FDG DHC SPECT-CT in the diagnosis and staging for lung cancer]. Zhonghua Zhong Liu Za Zhi; 2008 Dec;30(12):933-6
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  • Fifty-seven of the 71 patients had definite pathological or cytological diagnosis, consisting of 52 malignant lung tumors and 5 benign pulmonary nodules.
  • The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of staging hilar and mediastinal lymph nodes were 76.9%, 79.2%, 78.4%, 66.6%, 86.4% for conventional CT versus 61.5%, 75.0%, 70.3%, 57.1%, 78.3% for SPECT-CT (P > 0.05), respectively.
  • It can be used as a non-invasive supplementary tool for differential diagnosis between malignant and benign pulmonary lesions and in diagnosis of lymph node > 1 cm in diameter.
  • [MeSH-major] Carcinoma, Squamous Cell / diagnosis. Fluorodeoxyglucose F18. Lung Neoplasms / diagnosis. Neoplasm Staging. Tomography, Emission-Computed, Single-Photon / methods

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  • (PMID = 19173997.001).
  • [ISSN] 0253-3766
  • [Journal-full-title] Zhonghua zhong liu za zhi [Chinese journal of oncology]
  • [ISO-abbreviation] Zhonghua Zhong Liu Za Zhi
  • [Language] chi
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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37. Pawlak-Cieślik A, Szturmowicz M, Fijałkowska A, Tomkowski W, Kupis W, Langfort R, Demkow U, Wiechecka A, Orłowski T, Torbicki A: [Neoplastic pericarditis--the role of different diagnostic procedures]. Pol Arch Med Wewn; 2006 Jan;115(1):37-44
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  • Chest CT scan revealed the presence of enlarged mediastinal lymph nodes in 94% of pts with malignant pericarditis and only 11% of pts with non-malignant disease (p = 0.00001).
  • CEA > 5 ng/ml and Cyfra 21-1>50 ng/ml were found in 43% of the pts with malignant pericarditis and none of the pts with benign pericarditis.
  • [MeSH-minor] Adult. Aged. Antigens, Neoplasm / analysis. Cardiac Tamponade / diagnosis. Cardiac Tamponade / etiology. Diagnosis, Differential. Exudates and Transudates / chemistry. Exudates and Transudates / cytology. Female. Humans. Keratin-19. Keratins / analysis. Male. Middle Aged. Pericardial Effusion / diagnosis. Pericardial Effusion / etiology

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  • (PMID = 17278783.001).
  • [Journal-full-title] Polskie Archiwum Medycyny Wewnetrznej
  • [ISO-abbreviation] Pol. Arch. Med. Wewn.
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Poland
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / Carcinoembryonic Antigen; 0 / Keratin-19; 0 / antigen CYFRA21.1; 68238-35-7 / Keratins
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38. Aïssaoui R, Turki Z, Achiche A, Balti MH, Ben Slama C, Zbiba M: [Adrenal metastasis of a papillary thyroid cancer]. Ann Endocrinol (Paris); 2006 Sep;67(4):364-7
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  • [Transliterated title] Métastase surrénalienne d'un cancer papillaire de la thyroïde.
  • Histologic examination showed a benign cortical tumor.
  • PTC usually spreads to the cervical and mediastinal lymph nodes.
  • [MeSH-minor] Adrenalectomy. Female. Humans. Middle Aged. Neoplasm Metastasis. Tomography, X-Ray Computed. Treatment Outcome


39. Morikawa M, Demura Y, Ishizaki T, Ameshima S, Miyamori I, Sasaki M, Tsuchida T, Kimura H, Fujibayashi Y, Okazawa H: The effectiveness of 18F-FDG PET/CT combined with STIR MRI for diagnosing nodal involvement in the thorax. J Nucl Med; 2009 Jan;50(1):81-7
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  • The purpose of this study was to compare the efficacy of short-tau inversion-recovery (STIR) MRI and 18F-FDG PET/CT for the detection of metastasis in mediastinal and hilar lymph nodes in patients with lung cancer.
  • METHODS: Ninety-three patients with known or suspected lung cancer with mediastinal and hilar lymph node swelling underwent STIR MRI and 18F-FDG PET/CT examinations.
  • STIR MRI scans were obtained with a 2% copper sulfate phantom placed along the back of each patient, with the lymph node-to-phantom ratio calculated for quantitative analysis.
  • To evaluate the diagnostic capabilities of STIR MRI and 18F-FDG PET/CT, we used receiver-operating-characteristic curve analysis to determine the optimal thresholds for the lymph node-to-phantom ratio, visual score, and maximal standardized uptake value.
  • RESULTS: A total of 137 lymph nodes (82 malignant lesions, 55 benign lesions) were analyzed.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Magnetic Resonance Imaging. Male. Mediastinal Neoplasms / radiography. Mediastinal Neoplasms / radionuclide imaging. Mediastinal Neoplasms / secondary. Middle Aged. Neoplasm Staging. Phantoms, Imaging. Positron-Emission Tomography. Sensitivity and Specificity. Tomography, X-Ray Computed

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  • (PMID = 19091887.001).
  • [ISSN] 0161-5505
  • [Journal-full-title] Journal of nuclear medicine : official publication, Society of Nuclear Medicine
  • [ISO-abbreviation] J. Nucl. Med.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18
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40. Adhikari RC, Tuladhar A, Shrestha S, Sharma SK: Deep-seated thoracic and abdominal lesions: usefulness of ultrasound guided fine needle aspiration cytology, a 3 year experience. Nepal Med Coll J; 2010 Mar;12(1):20-5

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  • These included liver (125 cases), lung (81 cases), abdominal and mediastinal lymph nodes (29 cases), ovary (14 cases), omentum (12 cases), pancreas (10 cases), kidney (10 cases), mediastinum (8 cases), gall bladder (8 cases) etc.
  • In 264 cases (82.5%), FNAC was diagnostic with commonest diagnosis being malignant neoplasm (70.0%).
  • Benign neoplasm (3.1%) and non neoplastic lesion (9.4%) were also diagnosed by FNAC.

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  • (PMID = 20677604.001).
  • [Journal-full-title] Nepal Medical College journal : NMCJ
  • [ISO-abbreviation] Nepal Med Coll J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Nepal
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41. Kumasaka T, Seyama K, Mitani K, Souma S, Kashiwagi S, Hebisawa A, Sato T, Kubo H, Gomi K, Shibuya K, Fukuchi Y, Suda K: Lymphangiogenesis-mediated shedding of LAM cell clusters as a mechanism for dissemination in lymphangioleiomyomatosis. Am J Surg Pathol; 2005 Oct;29(10):1356-66
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  • Recent studies indicate that LAM cells can migrate or metastasize to form new lesions in multiple organs, although they show a morphologically benign appearance.
  • In this study, we further focused on the lymphatic abnormalities in LAM: LAM-associated chylous fluid (5 pleural effusion and 2 ascites), surgically resected diaphragm (1 patient), and axial lymphatic system including the thoracic duct, lymph nodes at various regions, and diaphragmatic lymphatic system (5 autopsy cases).
  • We identified LAM lesion in the diaphragm (2 of 5 autopy cases and one surgical specimen), thoracic duct (5 of 5), and lymph nodes (retroperitoneal (5 of 5), mediastinal (4 of 5), left venous angle (5 of 5) with total positive rate of 68% to 88% at each region of the lymph node, but less frequent or none at remote lymph nodes located away from the axial lymph trunk (cervical [1 of 5] and axillary [0 of 5]).
  • [MeSH-major] Endothelial Cells / pathology. Lymphangiogenesis. Lymphangioleiomyomatosis / pathology. Neoplasm Metastasis / pathology. Neoplastic Cells, Circulating / pathology

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  • (PMID = 16160479.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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42. Feller-Kopman D, Yung RC, Burroughs F, Li QK: Cytology of endobronchial ultrasound-guided transbronchial needle aspiration: a retrospective study with histology correlation. Cancer; 2009 Dec 25;117(6):482-90
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: Endobronchial ultrasound (EBUS) is a relatively new modality that can be used to guide transbronchial needle aspiration (TBNA) of mediastinal and hilar lymph nodes and peripheral lung lesions.
  • In this study, we have reviewed the cytological profile of 135 consecutive cases, including 71 lymph node cases, 4 lung cases, and 60 cases of both lymph node and lung sampling.
  • RESULTS: Of 131 cases of lymph node sampling, 45 cases (34.6%) were diagnosed as malignant, 73 cases (55.7%) as benign process, 5 cases (3.8%) as suspicious for malignancy, and 1 case (0.8%) as atypical cells.
  • Of the 64 cases of lung lesion sampling, 21 cases (32.8%) were diagnosed as malignant, 35 cases (54.7%) as benign process, 1 case (1.5%) as suspicious for malignancy, and 4 cases (6.3%) as atypical cells.
  • The lymph node nondiagnostic rate was 5.3%, whereas the nondiagnostic rate for lung lesions was 4.7%.
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Bronchi / ultrasonography. Female. Humans. Male. Middle Aged. Neoplasm Staging / methods. Predictive Value of Tests. Retrospective Studies. Sensitivity and Specificity

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  • [Copyright] (c) 2009 American Cancer Society.
  • (PMID = 19834962.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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43. Silvestri GA, Gould MK, Margolis ML, Tanoue LT, McCrory D, Toloza E, Detterbeck F, American College of Chest Physicians: Noninvasive staging of non-small cell lung cancer: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest; 2007 Sep;132(3 Suppl):178S-201S
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  • RESULTS: The pooled sensitivity and specificity of CT scanning for identifying mediastinal lymph node metastasis were 51% (95% confidence interval [CI], 47 to 54%) and 85% (95% CI, 84 to 88%), respectively, confirming that CT scanning has limited ability either to rule in or exclude mediastinal metastasis.
  • For PET scanning, the pooled estimates of sensitivity and specificity for identifying mediastinal metastasis were 74% (95% CI, 69 to 79%) and 85% (95% CI, 82 to 88%), respectively.
  • CONCLUSIONS: CT scanning of the chest is useful in providing anatomic detail, but the accuracy of chest CT scanning in differentiating benign from malignant lymph nodes in the mediastinum is poor.
  • [MeSH-minor] Clinical Trials as Topic. Diagnosis, Differential. Evidence-Based Medicine. Humans. Lymphatic Metastasis. Neoplasm Staging. Positron-Emission Tomography. Sensitivity and Specificity. Tomography, X-Ray Computed


44. Farah-Klibi F, Ferchiou M, Kourda J, El Amine O, Ferjaoui M, Ben Jilani S, Zermani R: [Parotid basal cell adenoma of membranous type]. Tunis Med; 2009 Feb;87(2):149-51
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  • [Transliterated title] Adenome a cellules basales de type membraneux de la parotide.
  • INTRODUCTION: Basal cell adenoma (BCA) is a rare benign neoplasm characterized by the basaloid appearance of the tumour cells and the lack of myxo-chondroid stromal component present in pleomorphic adenoma.
  • AIM: We report a case of basal cell adenoma of membranous type, highly suspected of malignancy because of the presence of mediastinal lymph nodes and pulmonary nodules which finally were related to an associated sarcoidosis.
  • A chest radiography noted mediastinal lymph nodes.
  • The CT-scan confirmed the presence of mediastinal and tracheal lymph nodes with pulmonary nodules.
  • Finally, the histological examination concluded to a basal cell adenoma of membranous type with sarcoidosis granulomas in the parotid and in the lymph nodes.
  • CONCLUSION: The BCA is a benign tumor located generally in the parotid gland.

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  • (PMID = 19522450.001).
  • [ISSN] 0041-4131
  • [Journal-full-title] La Tunisie médicale
  • [ISO-abbreviation] Tunis Med
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Tunisia
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45. Hürtgen M, Friedel G, Witte B, Toomes H, Fritz P: Systematic Video-Assisted Mediastinoscopic Lymphadenectomy (VAMLA). Thorac Surg Sci; 2005;2:Doc02

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  • Accurate mediastinal lymph node dissection during thoracotomy is mandatory for staging and for adjuvant therapy in lung cancer.
  • Lymph nodes were counted and compared to open lymphadenectomy.
  • Mean duration of anaesthesia was 84.6 (SD 35.8) minutes.In 7 patients radical lymphadenectomy was not intended because of bulky nodal disease or benign disease.
  • In two patients, 1 and 2 left over paratracheal nodes were counted respectively.
  • In 6 patients one single node and in the remaining 2 cases 5 and 8 nodes were found, respectively.
  • However these counts also included nodes from the ipsilateral main bronchus.
  • None of these nodes was positive for tumour.Average weight of the tissue that was harvested by VAMLA was 10.1 g (2.2-23.7, SD 6.3).
  • An average number of 20.5 (6-60, SD 12.5) nodes per patient were counted in the specimens.
  • This is comparable to our historical data from open lymphadenectomy.One palsy of the recurrent nerve in a patient with extensive preparation of the nerve and resection of 11 left-sided enlarged nodes was the only severe complication in this series.VAMLA seems to accomplish mediastinal nodal dissection comparable to open lymphadenectomy and supports video assisted surgery for lung cancer.
  • In neoadjuvant setting a correct mediastinal N-staging is achieved.

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  • (PMID = 21289921.001).
  • [ISSN] 1862-4006
  • [Journal-full-title] Thoracic surgical science
  • [ISO-abbreviation] Thorac Surg Sci
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Other-IDs] NLM/ PMC3011310
  • [Keywords] NOTNLM ; carcinoma, non-small-cell lung / lung neoplasm / mediastinoscopy / neoplasm staging / video-assisted surgery
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46. Querellou S, Keromnes N, Abgral R, Sassolas B, Le Roux PY, Cavarec MB, Le Duc-Pennec A, Couturier O, Salaun PY: Clinical and therapeutic impact of 18F-FDG PET/CT whole-body acquisition including lower limbs in patients with malignant melanoma. Nucl Med Commun; 2010 Sep;31(9):766-72
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  • In 28 cases, uptakes were located at once in the lower limbs and in the rest of the body (lung, liver, mediastinal and sub-diaphragmatic lymph nodes, adrenal glands, bone) corresponding to disseminated disease.
  • In five cases, PET/CT uptakes were located only in lower limbs; each pathological uptake corresponded to benign lesions.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Neoplasm Staging. Retrospective Studies

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  • [CommentIn] Nucl Med Commun. 2011 Jun;32(6):544-5 [21505291.001]
  • (PMID = 20585271.001).
  • [ISSN] 1473-5628
  • [Journal-full-title] Nuclear medicine communications
  • [ISO-abbreviation] Nucl Med Commun
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0Z5B2CJX4D / Fluorodeoxyglucose F18
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47. Lemaire A, Nikolic I, Petersen T, Haney JC, Toloza EM, Harpole DH Jr, D'Amico TA, Burfeind WR: Nine-year single center experience with cervical mediastinoscopy: complications and false negative rate. Ann Thorac Surg; 2006 Oct;82(4):1185-9; discussion 1189-90
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: Mediastinoscopy is a valuable tool for evaluating mediastinal pathology and is essential for establishing treatment strategies in most patients with lung cancer.
  • Pathology included lung cancer (n = 1,459), metastatic disease (n = 78), lymphoma (n = 51), and other benign disease (n = 557).
  • Thirty-two (57%) of the false negatives were due to metastatic disease in lymph nodes not normally biopsied during cervical mediastinoscopy (levels 5, 6, 8, or 9).
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. False Negative Reactions. Female. Humans. Lymphatic Metastasis / diagnosis. Male. Middle Aged. Neck. Neoplasm Staging. Retrospective Studies

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  • (PMID = 16996905.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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48. Marzano AV, Ghislanzoni M, Gianelli U, Caputo R, Alessi E, Berti E: Fatal CD8+ epidermotropic cytotoxic primary cutaneous T-cell lymphoma with multiorgan involvement. Dermatology; 2005;211(3):281-5
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  • At that time, despite the diagnosis of a benign disease, an adequate staging was performed, ruling out any extracutaneous involvement.
  • During hospitalization, multiple purpuric papules developed over the abdomen, and the disease spread to mediastinal lymph nodes, lungs and the central nervous system.
  • Among primary cutaneous T-cell lymphomas, the CD8+ epidermotropic cytotoxic subset comprises rare, highly aggressive forms characterized by metastatic spread to unusual sites such as the oral cavity, lungs, testis and the central nervous system but usually not to the lymph nodes.
  • [MeSH-minor] Aged. Antigens, CD8 / immunology. Fatal Outcome. Female. Femoral Artery. Humans. Neoplasm Metastasis. Thrombosis / etiology

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  • [Copyright] Copyright 2005 S. Karger AG, Basel.
  • (PMID = 16205076.001).
  • [ISSN] 1018-8665
  • [Journal-full-title] Dermatology (Basel, Switzerland)
  • [ISO-abbreviation] Dermatology (Basel)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antigens, CD8
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49. Annema JT, Versteegh MI, Veseliç M, Voigt P, Rabe KF: Endoscopic ultrasound-guided fine-needle aspiration in the diagnosis and staging of lung cancer and its impact on surgical staging. J Clin Oncol; 2005 Nov 20;23(33):8357-61
MedlinePlus Health Information. consumer health - Lung Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Endoscopic ultrasound (EUS) -guided fine-needle aspiration (FNA) is an accurate, safe, and minimally invasive technique for the analysis of mediastinal lymph nodes (LNs) and can additionally detect tumor invasion (T4) in patients with centrally located tumors.
  • PATIENTS AND METHODS: Two hundred forty two consecutive patients with suspected (n = 142) or proven (n = 100) lung cancer and enlarged (> 1 cm) mediastinal LNs at chest computed tomography were scheduled for mediastinoscopy/tomy (94%) or exploratory thoracotomy (6%).
  • RESULTS: EUS-FNA prevented 70% of scheduled surgical procedures because of the demonstration of LN metastases in non-small-cell lung cancer (52%), tumor invasion (T4) (4%), tumor invasion and LN metastases (5%), SCLC (8%), or benign diagnoses (1%).
  • Sensitivity, specificity, and accuracy for EUS in mediastinal analysis were 91%, 100% and 93%, respectively.
  • CONCLUSION: EUS-FNA qualifies as the initial staging procedure of choice for patients with (suspected) lung cancer and enlarged mediastinal LNs.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Algorithms. Female. Humans. Lymphatic Metastasis. Male. Mediastinum. Middle Aged. Neoplasm Staging / instrumentation. Predictive Value of Tests. Prospective Studies. Sensitivity and Specificity

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  • [CommentOn] J Clin Oncol. 2005 Nov 20;23(33):8283-5 [16219928.001]
  • (PMID = 16219935.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Comment; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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