Lung cancer has become perhaps the most important cancer in the United States. The incidence has continued to increase, and lung cancer is now the leading cause of cancer death.1 However, most patients with lung cancer have advanced-stage disease when they first present and are not amenable to curative treatment. For the remainder, a careful search for metastatic or locally invasive tumors must be made prior to potentially curative lung resection. The lymph node drainage system for the lungs lies primarily in the mediastinum, and because it is a compact space enclosed in a rigid, bony cage, finding small lymph nodes that contain cancer is challenging.
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