Contralateral cervical node metastases in lung cancer.

The importance of metastases in the cervical lymph nodes in lung cancer is now established. Long ago both Boyd (1886) and Abram (1910) referred to this diagnostic aid, and Packard (1917) stated that "if (enlarged) supraclavicular glands are present, excision should be resorted to and a specimen submitted to the microscope." However, it was Daniels (1949) who proposed biopsy of non-palpable cervical lymph nodes " on the homolateral side of the pulmonary or chest disease." This procedure has now been carried out in many centres for over a decade. The difficulties which have crystallized out are the subject of this paper.