A Simple Cervicomediastinal Exploration for Tissue Diagnosis of Intrathoracic Disease

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Abstract
A technique for the diagnosis of intrathoracic disease that combines scalene-lymph-node biopsy with exploration of the superior mediastinum is described. One hundred and forty-two such explorations are reviewed, and the results analyzed. A positive tissue diagnosis of tumor, sarcoidosis or tuberculosis was made in 31.7% of the cases. In 78 proved cases of carcinoma of the lung, 31 showed metastases to the superior mediastinal or cervical lymph nodes not evident on physical examination. The implications of such metastases in the decision to use or forego surgical treatment are considered.