Ultrasound and ultrasound guided biopsy, CT and lymphography in the diagnosis of retroperitoneal metastases in testicular cancer.
A retrospective study of bipedal lymphography (BL), computed tomography (CT) and ultrasonography (US) of retroperitoneal lymph nodes has been carried out in 95 patients with newly diagnosed testicular cancer. Twenty-one patients had abnormal lymph nodes at the time of staging. The diagnostic accuracies of CT and US were almost identical with a sensitivity of 80% and 76% respectively and a specificity for both of 100%. BL was performed in 84 patients and was in accordance with US and CT in 66 cases. In 2 cases only BL was positive, while 16 had equivocal results of lymphography, of whom 5 had metastases. Nine patients relapsed to the retroperitoneal lymph nodes during observation, reducing CT/US sensitivity for macroscopic and microscopic disease to 63%. US-guided biopsy was performed in a total of 28 patients at the time of staging or during follow-up. Twenty-three patients had malignant findings and 5 verified benign lesions. US represents a cheap and accurate alternative to CT in the detection of metastatic retroperitoneal lymph nodes. US and US-guided biopsy is indicated supplementary to CT in cases with borderline enlarged nodes on CT. Furthermore, US-guided biopsy should always be performed to verify or exclude relapse, when follow-up examinations reveal abnormal abdominal findings.
Damgaard-Pedersen
K
K
Department of Ultrasound, Herlev Hospital, University of Copenhagen, Denmark.
von der Maase
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D006801:Humans; D008220:Lymphography; D008297:Male; D008875:Middle Aged; D012186:Retroperitoneal Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000556:secondary*; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography