Table 2.
Site of primary lung tumor |
Most common site(s) of MLN metastasis |
Minimally invasive technique for MLN diagnosis |
---|---|---|
Right upper lobe | 4R | EBUS-TBNA |
Right middle lobe | 4R, 7 | EBUS-TBNAb |
Right lower lobe | 4R, 7 | EBUS-TBNAb |
Left upper lobe | 5, 6 | EUS-FNAc |
Left lower lobe | 5, 6 | EUS-FNAc |
According to site of primary non-small-cell lung cancer and recommended primary investigation.
Posterior station 7 nodes may also be sampled by EUS-FNA.
EUS-FNA is not able to sample station 6 (para-aortic) MLNs and left video-assisted thoracic surgery or left anterior mediastinotomy may be preferred.
Abbreviations: EBUS-TBNA, endobronchial ultrasound-guided transbronchial needle aspiration; EUS-FNA, endoscopic ultrasound-guided fine-needle aspiration; MLN, mediastinal lymph node.