This is a study of routine neck ultrasound performed by respiratory physicians in patients with mediastinal lymphadenopathy and suspected lung cancer

In the first phase of the study a respiratory physician was trained to perform neck ultrasound and needle sampling of enlarged cervical lymph nodes according to preset criteria. In the second phase patients with suspected lung cancer and enlarged mediastinal lymph nodes underwent routine neck ultrasound and enlarged cervical lymph nodes were sampled using fine needle and or core needle biopsy.

The outcomes of interest in the study were the rate of malignant cervical lymphadenopathy defined as pathological evidence of cancer in neck lymph node samples consistent with a lung primary, adequacy of needle sampling, patient reported experience assessed by a visual analogue of discomfort associated with needle neck sampling and EBUS, and the proportion of patients that had nodal upstaging

Inclusion Criteria:

• Suspected and later on confirmed lung cancer
• Presence of at least one mediastinal lymph node measuring > 10 mm in short diameter on computerised Tomography

Exclusion Criteria:

• Age <18
• History any malignancy apart from non-melanomatous skin cancer
• Inability to give informed consent

Patients with suspected and later on confirmed lung cancer with evidence of enlarged mediastinal lymph node(s) measuring > 10 mm in short diameter on Computerised Tomography