Loculated neonatal chylothorax treated with octreotide: complete recovery while on unrestricted full fat breast milk.

prognosis after surgical resection can be expected in comparison with patients with preoperative confirmed N2 disease [8]. An additional advantage of the PET scan in comparison with mediastinoscopy is that the PET scan can indicate suspected lymph nodes in stations not amenable to mediastinoscopy (eg, paraesophageal or supraclavicular). Staging of the mediastinum using positron emission tomography is definitely better than staging using computed tomography alone, and therefore the PET scan has a definite role in noninvasive mediastinal staging independent of the availability and expertise in mediastinoscopy. In our view, the PET scan is able to reduce the need for mediastinoscopy and reduce the number of unnecessary thoracotomies. A clinician must always seek an accurate preoperative staging with a minimal need for invasive procedures. The use of PET scanning needs further validation in outcome studies. In a randomized design, these studies should examine whether positron emission tomography actually improves NSCLC management (eg, by decreasing the number of unnecessary invasive procedures or by improving the survival). In the future, fusion of the CT scan with the PET scan into one test may be helpful to further improve the diagnostic accuracy of these noninvasive imaging modalities. We think that our considerations are not a matter of relearning lessons from the past, but are useful contributions to improvement of clinical staging of NSCLC patients. In that regard, we are making progress.