Scalene Node Biopsy: Its Value as a Diagnostic Aid in Chest Diseases

¹ The Department of Pathology, Sydney University.

1. The first series of scalene lymph node examinations from routine autopsy material is presented. Of 123 cases, in which nodes from both sides of the neck were examined, the overall incidence of positive findings was 16.3 per cent; 45.5 per cent were positive in cases in which lymph node involvement would have been possible. The incidence and distribution of scalene node changes in cases of abdominal malignancy supported the hypothesis that the left node is involved first in such cases.

2. Indications for scalene node biopsy are: (a) In obscure intrathoracic conditions to attempt to establish a diagnosis e.g. in carcinoma or in sarcoidosis of the lung. (b) In cases in which the diagnosis is certain but in which involvement of these nodes will affect the prognosis, treatment or management of the patient, i.e. when carcinoma of the lung has metastasized to the scalene nodes. (c) For diagnosis of disease involving lymph nodes, e.g., leukaemia, Hodgkin's disease, and lymphosarcoma.