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Computed tomography (CT) that is specifically aimed at evaluating lung cancer includes the chest and the upper abdomen. This allows for evaluation of other relevant anatomic structures such as nearby lymph nodes, adrenal glands, liver, and bones which may show evidence of metastatic spread of disease. [4]
The American Thoracic Society has standardized the nomenclature of lymph nodes in the chest. [29] There are fourteen numbered nodal stations. Lymph nodes considered to be in the mediastinum are stations 1–9, which are thus potential N2 or N3 locations, while stations 10-14 are hilar and peripheral nodes, and thus potential N1 locations.
Lymph node biopsy is a test in which a lymph node or a piece of a lymph node is removed for examination under a microscope (see: biopsy). The lymphatic system is made up of several lymph nodes connected by lymph vessels. The nodes produce white blood cells (lymphocytes) that fight infections. When an infection is present, the lymph nodes swell ...
[29] [30] Lymph node staging depends on the extent of local spread: with the cancer metastasized to no lymph nodes (N0), pulmonary or hilar nodes (along the bronchi) on the same side as the tumor (N1), mediastinal or subcarinal lymph nodes (in the middle of the lungs, N2), or lymph nodes on the opposite side of the lung from the tumor (N3). [30]
[3] [13] [14] Diagnosis, if enlarged lymph nodes are present, is usually by lymph node biopsy. [1] [2] Blood, urine, and bone marrow testing may also be useful in the diagnosis. [2] Medical imaging may then be done to determine if and where the cancer has spread. [1] [2] Lymphoma most often spreads to the lungs, liver, and brain. [1] [2]
The primary function of lymph nodes is the filtering of lymph to identify and fight infection. In order to do this, lymph nodes contain lymphocytes, a type of white blood cell, which includes B cells and T cells. These circulate through the bloodstream and enter and reside in lymph nodes. [24] B cells produce antibodies.
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