Prescalene Lymph Node Biopsy

In the presence of an undiagnosed intrathoracic lesion it is obvious that palpable supraclavicular lymph nodes should be submitted to biopsy. It is less clear whether prescalene node biopsy is indicated in the absence of palpable nodes. It is the purpose of this study to review a series of simple prescalene node biopsies to determine the value of this procedure as a routine, particularly with respect to carcinoma of the lung. Daniels,1in 1949, and, later, Weiss et al.,2Johnson and MacCurdy,3and Storey and Reynolds4first described prescalene node biopsy as a means of diagnosing intrathoracic disease. Several subsequent series have been reported that have not distinguished between patients with palpable and those with nonpalpable supraclavicular nodes. Among these,5-9positive diagnoses were obtained in 25% to 40%. Sarcoidosis (Boeck's Sarcoid) was the most frequent diagnosis in the three series of over 100 cases.5,6,9