Excision of the scalene nodes from the supraclavicular or subclavian triangle as an aid in establishing a diagnosis for pulmonary or intrathoracic lesions, both benign and malignant, was reported by Daniels in 1949.1 This accurate adjunctive histologic or bacteriologic diagnostic procedure or both for lesions in these areas has gained widespread use.1-16
The incidence of positive results is dependent upon a careful and complete dissection and excision of the total fat pad of the areas mentioned above. As experience is gained with this modality, the surgeon can extend his dissection medialward to include, in some instances, the paratracheoesophageal nodes in the inferior-anterior aspect of the neck, as well as nodes in the upper aspect of the anterosuperior mediastinum. When this combined type of dissection is performed, the positive yields will be much higher than in the supraclavicular dissection alone.
In this program full cooperation of a qualified pathologist
Palumbo LT, Sharpe WS. Scalene Node BiopsyCorrelation With Other Diagnostic Procedures in 550 Cases. Arch Surg. 1969;98(1):90-93. doi:10.1001/archsurg.1969.01340070108023