[Four cases of subpleural intrapulmonary lymph node]

We presented four cases of subpleural intrapulmonary lymph node showing the indeterminate pulmonary nodule. Case 1 was a 54-year-old male who had a subpleural nodule, 7 mm in diameter in the right S8 segment on chest CT. This nodule showed difficulty to differentiate from small peripheral lung carcinoma. Case 2 was a 72-year-old male who was diagnosed adenocarcinoma of lung. Chest CT showed multiple pulmonary nodules, about 5 mm in diameter except main tumor in the right middle and lower lobes. These nodules showed difficulty to differentiate from intrapulmonary metastasis. Case 3 was a 70-year-old female who was diagnosed lung metastasis of sigmoid colon cancer. Chest CT showed a subpleural nodule, 3 mm in diameter except main tumor in the right S9 segment. This nodule also showed difficulty to differentiate from lung metastasis. Case 4 was a 40-year-old female who had a subpleural nodule, 10 mm in diameter in the right S9 segment. This nodule also showed difficulty to differentiate from small peripheral lung carcinoma. We diagnosed subpleural intrapulmonary lymph nodes, in case 1, 2 and 3, by open thoracotomy and in case 4, thoracoscopic surgery. It should be always kept in mind that subpleural pulmonary nodules in especially middle and lower lobes of lung might be intrapulmonary lymph nodes. Thoracoscopic surgery would be a very useful procedure for diagnosis and therapy of subpleural intrapulmonary lymph nodes.