AXILLARY LYMPH-NODE METASTASES OF BRONCHOGENIC-CARCINOMA

Background, Metastasis of bronchogenic carcinoma to axillary lymph nod es is rare. The pathways and possible significance of axillary lymph n ode metastasis from bronchogenic carcinoma were investigated. Methods. Seventeen patients with probable axillary lymph node metastases from bronchogenic carcinoma were identified by computed tomography, There w ere 15 nonsmall cell lung cancers and 2 small cell lung cancers. Axill ary lymph node metastasis was proven by biopsy in six cases. Metastase s were presumed because of an increase in the size of axillary lymph n odes compared with prior studies in six patients and enlarged axillary lymph nodes associated with biopsy-proven ipsilateral supraclavicular lymph node metastasis in five patients. Results. Four of 10 right-sid ed lung cancers had ipsilateral and six had contralateral axillary lym ph node metastases. Six of seven left-sided cancers had ipsilateral an d one had contralateral axillary lymph node metastases. Patients with ipsilateral lymph node disease had chest wall involvement and/or supra clavicular and mediastinal lymph node metastases. All seven patients w ith contralateral axillary lymph node metastases had supraclavicular a nd/or mediastinal lymph node metastases. Conclusion, Bronchogenic carc inoma may involve ipsilateral axillary lymph nodes via either chest wa ll invasion or retrograde spread from supraclavicular lymph nodes. Con tralateral axillary lymph node involvement requires involvement of con tralateral mediastinal and supraclavicular lymph nodes with retrograde spread to the axillary lymph nodes.