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Ann Thorac Surg 2006;81:1547
© 2006 The Society of Thoracic Surgeons

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Correspondence

Detecting Metastasis of Lung Cancer in Mediastinal Lymph Nodes: The Discrepancy Between Cytology and Histology

Division of Surgery for Chest Diseases, Toneyama National Hospital , 5-1-1 Toneyama, Toyonaka , Osaka, 560-8552 Japan

(Email: nsawabata{at}m5.dion.ne.jp).

To the Editor:

Dr Okubo and his colleagues reported on the efficacy of stump cytology technique for diagnosing mediastinal lymph node metastasis [1]. Their conclusion is that imprint cytology for detecting metastasis of lung cancer in mediastinal nodes has high sensitivity and accuracy and is no less useful than a histologic examination.

I agree to their opinion that the cytological technique poses comparable diagnostic power. However, the sensitivity of the cytological technique is sometimes too high ie, contaminated cells can be diagnosed as malignant positive [2]. Mediastinal lymph node resection is carried out from inside of the pleural space, thus contamination of malignant cells from the pleural space should be considered. In addition, metastasized malignant cells in the lymph duct also may be recognized as lymph node metastasis using cytological techniques. There are many obscure points in their study; status of the malignant effusion and pleural lavage cytology, the status of metastasis to the lymph ducts, and the status of micrometastases using a specific method.

In practice, it is very difficult to treat the discrepancy between cytology and histology [3]. However, as is the cases of their study, placing the diagnostic priority on cytology may have the potential of excessive diagnosis.

	References

Top References

 

1. Okubo K, Kato T, Hara A, Yoshimi N, Takeda K, Iwao F. Imprint cytology for detecting metastasis of lung cancer in mediastinal lymph nodes Ann Thorac Surg 2004;78:1190-1193.[Abstract/Free Full Text]
2. Carlin BW, Harrell 2nd JH, Fedullo PF. False-positive transcarinal needle aspirate in the evaluation of bronchogenic carcinoma Am Rev Respir Dis 1989;140:1800-1802.[Medline]
3. Sawabata N, Matsumura A, Ohota M, et al. Thoracic Surgery Study Group of Osaka University Cytologically malignant margins of wedge resected stage I non-small cell lung cancer Ann Thorac Surg 2002;74:1953-1957.[Abstract/Free Full Text]

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				K. Okubo Reply. Ann. Thorac. Surg., April 1, 2006; 81(4): 1547 - 1547. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Noriyoshi Sawabata Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sawabata, N. Search for Related Content PubMed PubMed Citation Articles by Sawabata, N. Related Collections Lung - cancer Related Article