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Tuberc Respir Dis (Seoul). 2018 Oct;81(4):339-346. doi: 10.4046/trd.2017.0121. Epub 2018 Jun 19.

Clinical Characteristics of False-Positive Lymph Node on Chest CT or PET-CT Confirmed by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Lung Cancer.

Author information

1
Division of Pulmonary, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
2
Department of Nuclear Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.
3
Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
4
Department of Radiation Oncology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
5
Division of Medical Oncology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
6
The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
7
Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
8
Department of Thoracic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
9
Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
10
Clinical Research Coordinating Center, College of Medicine, The Catholic University of Korea, Seoul, Korea.
11
The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea. cmcksj@catholic.ac.kr.

Abstract

BACKGROUND:

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure to evaluate suspicious lymph node involvement of lung cancer because computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography-CT (PET-CT) have limitations in their sensitivity and specificity. There are a number of benign causes of false positive lymph node such as anthracosis or anthracofibrosis, pneumoconiosis, old or active tuberculosis, interstitial lung disease, and other infectious conditions including pneumonia. The purpose of this study was to evaluate possible causes of false positive lymph node detected in chest CT or PET-CT.

METHODS:

Two hundred forty-seven patients who were initially diagnosed with lung cancer between May 2009 and December 2012, and underwent EBUS-TBNA to confirm suspicious lymph node involvement by chest CT or PET-CT were analyzed for the study.

RESULTS:

Of 247 cases, EBUS-TBNA confirmed malignancy in at least one lymph node in 189. The remaining 58 patients whose EBUS-TBNA results were negative were analyzed. Age ≥65, squamous cell carcinoma as the histologic type, and pneumoconiosis were related with false-positive lymph node involvement on imaging studies such as chest CT and PET-CT.

CONCLUSION:

These findings suggest that lung cancer staging should be done more carefully when a patient has clinically benign lymph node characteristics including older age, squamous cell carcinoma, and benign lung conditions.

KEYWORDS:

Chest; Lung Neoplasms; Lymph Node; Positron Emission Tomography Computed Tomography; Tomography, X-Ray Computed

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