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Intrathoracic lymph node metastases from extrathoracic neoplasms

T C McLoud, L Kalisher, P Stark

    AJR. American Journal of Roentgenology
    |September 1, 1978
    PubMed
    Summary

    Extrathoracic cancers frequently spread to mediastinal and hilar lymph nodes. The right paratracheal chain was the most common site of metastasis in these cancer patients.

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    Area of Science:

    • Oncology
    • Radiology
    • Thoracic Medicine

    Background:

    • Extrathoracic malignant neoplasms can metastasize to intrathoracic lymph nodes.
    • Mediastinal and hilar adenopathy can be a sign of metastatic disease.

    Purpose of the Study:

    • To investigate the incidence and patterns of intrathoracic lymph node metastases from extrathoracic malignant neoplasms.
    • To identify the primary tumor types and lymph node distribution involved in such cases.

    Main Methods:

    • Retrospective review of clinical records of 1,071 patients with extrathoracic malignant neoplasms.
    • Analysis of chest films for evidence of mediastinal and/or hilar lymph node metastases.
    • Categorization of primary malignancies and identification of affected lymph node groups.

    Main Results:

    • 25 out of 163 patients with abnormal chest films showed evidence of lymph node metastases.
    • Common primary sites included head and neck, genitourinary, breast, and malignant melanoma.
    • The right paratracheal lymph node chain was the most frequently involved group (60%).

    Conclusions:

    • Metastatic disease from extrathoracic cancers is a significant cause of mediastinal and hilar adenopathy.
    • Radiographic detection of these metastases is crucial for diagnosis and management.
    • Consideration of extrathoracic primary malignancies in the differential diagnosis of hilar and mediastinal adenopathy is essential.

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