Computed tomographic evaluation of false positive cases of lymph node metastasis from primary lung cancer

Abstract

In patients with surgically resected primary lung cancers, the thoracic CT findings suggesting a diagnosis of metastasis in mediastinal lymph nodes were compared with postoperative histological finding. There were 48 false positive cases. The ages ranged from 37 to 79, and 37 were men. In comparison of clinical N and pathological N, accuracy of the former in relation to based on pathological N was 66.3%. Our results suggested no difference in histological type, size and location of the primary tumor or location of the enlarged lymph nodes. However, in 29 of the 48 patients, there were other lesions, such as postinflammatory changes, calcified nodules or bullae. Assumption of metastasis disease can lead to inaccurate staging of the disease and inaccurate treatment and prognosis of the patients. Analysis of a larger series is needed. Furthermore, in operable cases, other modalities such as MRI, endobronchial ultrasound, and mediastinoscopic biopsy should be performed to adequately exclude metastatic disease.