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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 1989-90, all 37 lung cancer patients scheduled for surgery underwent transesophageal endoscopic ultrasonography (EUS) for pre-operative detection of hilar and mediastinal lymph node metastases. An electronic ultrasonic fiberscope with a linear array (EPB-503-FS, Machida-Toshiba) was used. Of 380 nodes surgically removed and that could have been detected by EUS, the detection rates for histologically metastatic and non-metastatic nodes were 65% (33 of 51) and 44% (144 of 329), respectively (p less than 0.01). Metastatic nodes were detected readily in every lymph node site, especially subaortic and subcarinal. Non-metastatic nodes were detected at low rates, especially in the superior mediastinum, paratracheal, and tracheobronchial locations. For greater long or short axes of the detected nodes, or for rounder nodes, the metastasis rate was higher. Detected nodes were classified into six types by their internal echo patterns; three were rarely metastatic (called "negative") and the other three were often metastatic (called "positive"). Of the "negative" nodes histologically proved to be metastatic, metastasis was often diffuse. The "positive" nodes found to be metastatic tended to have one of two patterns of internal echoes when invasion was diffuse and a third pattern when it was localized. In an examination of the diagnostic usefulness of EUS, we made more correct diagnoses from the internal echo pattern than by reference to either the long or short axis alone. The short axes, node shape, and internal echoes were examined by Hayashi's second method of quantification. The sensitivity, specificity, and accuracy of the diagnoses were 85%, 84%, and 84%, respectively, superior to those by computed tomography done of the same patients.
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PMID:Patterns of internal echoes in lymph nodes in the diagnosis of lung cancer metastasis. 835 81

Fifty patients with lung cancer underwent transesophageal endoscopic ultrasonography (EUS) for preoperative detection of metastases to the hilar and mediastinal lymph nodes. An electronic ultrasonic fiberscope with a linear array (EPB-503-FS, Machida-Toshiba) was used. Later, in surgery, a total of 513 nodes that could have been detected by EUS were removed. Of these, 54 nodes were found to be metastatic histologically, and 459 were non-metastatic. The rate of detection by EUS was 65% (35/54) for the metastatic nodes; the rate was 41% (186/459) for the non-metastatic nodes (p less than 0.01). Metastatic nodes were detected at high rates in every lymph node site. Non-metastatic nodes were detected at low rates in sites 1, 2, and 4, and at the highest rate in site 7. Metastatic nodes had characteristic internal echoes, affected by the extent of tumor and necrosis present in a node, and were detected more easily than non-metastatic nodes. For larger or rounder nodes, metastasis was more common (p less than 0.01). Lymph nodes that could be detected were classified into six types by their internal echo patterns; three of these types were rarely metastatic, and were called 'negative'; the other three were often metastatic, and were called 'positive'. In histological examinations, of the 'negative' nodes found in fact to be metastatic histologically, invasion by the tumor tended to be diffuse and necrosis was minute. The 'positive' nodes that were in fact metastatic tended to have one of two internal echo patterns (depending on the amount of necrosis) when invasion was diffuse, and a third pattern when invasion was localized.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Endoscopic ultrasonography for preoperative diagnosis of the hilar and mediastinal lymph node metastases in lung cancer]. 163 42