Mediastinoscopy in bronchogenic carcinoma.

Mediastinoscopy was performed in 470 patients with bronchogenic carcinoma in the ENT Department, Aalborg. The histological diagnoses were 195 squamous cell carcinomas, 149 adenocarcinomas, and 126 anaplastic carcinomas. Metastases in the mediastinal lymph nodes were found in 177 of the 470 patients (38%). Metastatic lymph nodes were found in approximately one fifth of the squamous cell carcinomas, in almost half of the adenocarcinomas, and in about half of the anaplastic carcinomas. The need is emphasized for lymph node biopsy from both right and left tracheobronchial angles and inferior to the bifurcation irrespective of the site of the carcinoma. Contralateral metastasis was found in approximately one third of the cases, and a positive biopsy from the nodes inferior to the bifurcation was found in about 40% of the patients in whom metastasis in the mediastinum were detected. In 10% of the patients, cytological and histological examinations of specimens obtained by bronchoscopy were negative, and the diagnosis of lung cancer was made by mediastinoscopy exclusively. The value of mediastinoscopy was particularly high in the diagnosis of adenocarcinomas.