Role for sampling nonpalpable supraclavicular lymph nodes found by ultrasound at the time of EBUS-TBNA: A single-center pilot study

The management of lung cancer relies principally on the histologic type and stage of the tumor whereby supraclavicular (SCLN) involvement represents inoperable disease. In the literature, palpation alone is not sensitive enough to detect SCLN disease; therefore, other modalities such as ultrasound could be used to detect an enlarged nonpalpable lymph node. We present a study of 10 patients who underwent ultrasound and fine-needle aspiration of SCLN's presenting for bronchoscopy and endobronchial ultrasound-guided transbronchial needle aspiration for presumed malignant abnormality in the lung. We have demonstrated that ultrasound of SCLN was feasible and resulted in 90% histopathologic diagnosis while avoiding bronchoscopy in 90% of patients as well. In conclusion, we propose that ultrasound fine-needle aspiration of SCLN is feasible and can be highly diagnostic in these high-risk patients.