Ipsilateral mediastinal metastatic adenopathy, including upper, aortico-pulmonary and lower mediastinum, and subcarinal
nodes, is considered as N2.
N2 Involvement of primary tumour that metastasis to the mediastinal or subcarinal
The CT of the thorax demonstrated multiple conglomerate mediastinal lymphadenopathies in paratracheal, aortopulmonary, subcarinal
, and right paraesophageal regions [Figure 1].
As mediastinoscopy require general anesthesia allows access only to paratracheal, and subcarinal
lymph nodes and in many cases require an inpatient stay.
Chest computed tomography (CT) was performed with a prediagnosis of TB: multiple LAPs in the pretracheal, pre and subcarinal
, and right hilar regions (conglomerated appearance in places); air bronchograms leading to complete air loss in the posterior segment of the upper lobe and in the middle lobe in the right lung with ectasic bronchial structures in the basal segment in the middle lobe; increased density compatible with collapse-consolidation with cavitation and increased ground-glass density in were found both upper lobes and in the posterior segment of the lower lobe in the left lung (Figure 3, 4).
The use of a laryngeal mask airway allows access to upper paratracheal, subcarinal
nodes which are not accessible with endotracheal tube in place.
[.sup.18]F-FDG PET/CT identified subcarinal
, right hilar and left interlobar hypermetabolic lymph nodes in one of the six patients with a false positive result (Figure 2).
Abnormal increased-activity involvements were reported in the lymph nodes in the right supraclavicular region, right anterior mediastinal area, left upper paratracheal, precarinal, bilateral hilar, subcarinal
, and paraesophageal areas.
MRI can play a complementary role in the staging of lung cancer in cases of superior sulcus tumor; pericardial involvement, tumor extension in subcarinal
regions and invasion of the superior vena cava.
EBUS-TBNA was performed to puncture the subcarinal
lymph node (#7) on August 17, 2016.
In many studies, various other risk factors that necessitate the extra-cervical approach were identified, such as airway emergency, superior vena cava syndrome, subcarinal
extension and harder thyroid tissue (12,21).
A total of 2298 lymph node stations were sampled: 1003 superior mediastinal: 2 high upper station #1, 56 station #2R, 8 station #2L, 740 station #4R, and 197 station #4L; 789 subcarinal
station #7; 506 N1 nodes: 57 hilar (37 station #10R and 20 station #10l), 365 interlobar (191 station #11R and 174 station #11L), 83 lobar (53 station #12R and 30 station #12L), and 1 segmental station #13L.