does lymph node size matter?
INTRODUCTION: Transoesophageal endoscopic ultrasound with fine-needle aspiration (EUS-FNA) is a minimally invasive procedure to demonstrate unresectability in lung cancer patients with enlarged malignant mediastinal lymph nodes (MLN). We compared the performance of EUS-FNA to show malignant invasion in enlarged versus small MLN. METHODS: A single center analysis was performed in lung cancer patients with a suspicion for malignant MLN invasion based on the available imaging. In these patients, EUS-FNA was presumed to impact the diagnostic course since patients underwent surgical-pathologic verification only when EUS-FNA did not demonstrate MLN invasion. RESULTS: We evaluated 100 lung cancer patients in whom MLN invasion was presumed based on the available imaging. In 75 patients (75%), there was at least one enlarged MLN, whereas in 25 patients (25%), only small MLN were found. The sensitivity and negative predictive value to detect malignancy in enlarged MLN was 96% (95% confidence int