XXXX revisited. Analysis with clinicopathologic correlation of 152 fine-needle aspiration biopsies of supraclavicular lymph nodes.

@entity1 @entity32 @entity5 @entity22336 @entity530 @entity1778 @entity3 @entity1893 @entity978
OBJECTIVE: The left supraclavicular lymph node ( @entity22336 ) may be involved by metastatic @entity5 , including those of abdominal or pelvic origin. Almost all previous studies have been based on examination of surgically sampled tissue or postmortem examination. To our knowledge, there has not been a study for nearly 40 years addressing the metastatic pattern to the left supraclavicular lymph node. Furthermore, there has been no study comparing left with right supraclavicular lymph node @entity3 or the utilization of fine-needle aspiration biopsy to samples these sites. DESIGN: A retrospective review of 152 fine-needle aspiration biopsies of supraclavicular lymph nodes was performed, and the @entity5 were grouped into six diagnostic categories from five primary regions. RESULTS: The @entity1 ranged in age from 2 years to 94 years (average, 55 years) and consisted of 66 males and 83 females. Three @entity1 were biopsied twice. Of the 152 fine-needle aspirations, 87 (57.2%) were of the left supraclavicular lymph node and 65 (42.8%) of the right supraclavicular lymph node. Of the 96 biopsies positive for @entity5 , 58 (60.4%) were biopsies of the left and 38 (39.6%) were of the right supraclavicular lymph nodes. Sixteen of 19 @entity530 and all six primary @entity5 metastasized to the left supraclavicular lymph node. Thorax, breast, and head and neck @entity5 showed no differences in metastatic patterns to the right and left supraclavicular lymph nodes. Ten @entity1 (10.4% of positive nodes) had a diagnosis of @entity1893 , @entity1778 , or @entity978 . Six @entity1 (7.1% of positive nodes) had a @entity3 of unknown primary site, and 19 cases (19.8%) had @entity32 ; seven of the latter cases demonstrated acid-fast bacilli in the aspirated smears. CONCLUSIONS: Fine-needle aspiration biopsy is an excellent initial procedure in the workup of an enlarged supraclavicular lymph node. Our study confirmed that @entity5 originating in the pelvis or abdomen were significantly more likely to metastasize to the left supraclavicular lymph node and that the primary site and types of @entity5 that involved the left supraclavicular lymph node were different from those involving the right supraclavicular lymph node.
