Fine needle aspiration: Clinically palpable neck nodes can be aspirated or biopsied under local anesthesia . Areas of adenopathy, both within and beyond the ‘range’ of mediastinoscopy, have been successfully biopsied using CT-guided techniques with a reported sensitivity of 88% and specificity of 100% . The results are operator-dependant, and each institution must evaluate its own results before making firm conclusions regarding the use of this method in their own setting. Transesophageal ultrasound-guided needle biopsy has also been described for selected patients .
Scalene node biopsy: While palpable scalene nodes should be biopsied, routine biopsies have not been performed for the past 20 to 30 years. However, a recent report documented microscopic involvement of the scalene nodes in 15% of patients with positive N2 disease and 68% of patients with contralateral disease, and recommended routine mediasti-noscopic scalene node biopsies in such patients . Thoracoscopy: Thoracoscopy can be used to biopsy many of the nodal areas, but it is particularly useful for assessing the posterior subcarinal and aortopulmonary window nodes, and has been advocated as a routine prethoracotomy staging tool by some centres . Mediastinoscopy still appears superior in its ability to assess the upper mediastinal nodes . Looking for a great online pharmacy you could trust and where you could find proventil inhaler dosage at best prices? You have one pharmacy like that already and can finally enjoy the best quality of service ever experienced.