title: Epstein-Barr virus detection in neck metastases by in-situ hybridization in fine-needle aspiration cytologic studies: an aid for differentiating the primary site.
abstract: BACKGROUND
  Nasopharyngeal carcinoma (NPC) is strongly associated with Epstein-Barr virus (EBV). The metastasis to cervical lymph nodes represents a frequent initial manifestation of NPC. The usefulness of EBV detection by polymerase chain reaction (PCR) in the diagnosis of occult NPC with cervical metastasis has been reported. Our previous study showed that EBER1 in-situ hybridization was somewhat more sensitive and specific than PCR in detecting EBV in the evaluation of specimens from a population at high risk for NPC.
  
  
  METHODS
  Fine-needle aspiration cytologic specimens of neck masses from 30 patients were investigated, including 10 NPC primary tumors, 19 squamous cell carcinomas from other sites of the head and neck (9 oral cavity, 2 paranasal sinuses, 2 oropharynx, 3 larynx, and 3 hypopharynx), and 1 diffuse large-cell lymphoma. EBER1 in-situ hybridization was performed on direct smears made from aspirates.
  
  
  RESULTS
  EBER1 signals were detected in all neck metastases from the nasopharynx but none of the specimens from other primary sites.
  
  
  CONCLUSIONS
  This study suggests that EBER1 in-situ hybridization can be used as a supplemental tool for differential diagnosis whenever fine-needle aspiration cytologic examination is presented with a neck metastasis without knowing the primary site.
authors.affiliation: Department of Pathology, National Cheng Kung University Medical College, Tainan, Taiwan.
authors.forename: W Y
authors.initials: WY
authors.lastname: Lee
authors.forename: J R
authors.initials: JR
authors.lastname: Hsiao
authors.forename: Y T
authors.initials: YT
authors.lastname: Jin
authors.forename: S T
authors.initials: ST
authors.lastname: Tsai
mesh_terms: D001707:Biopsy, Needle; D002277:Carcinoma / Q000473:pathology / Q000556:secondary* / Q000821:virology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary / Q000821:virology; D002467:Cell Nucleus / Q000473:pathology / Q000821:virology; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000821:virology; D006566:Herpesviridae Infections / Q000150:complications / Q000175:diagnosis; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D017403:In Situ Hybridization; D008207:Lymphatic Metastasis; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology / Q000821:virology; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000821:virology; D009382:Neoplasms, Unknown Primary / Q000821:virology*; D016133:Polymerase Chain Reaction; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013624:Taiwan; D014412:Tumor Virus Infections / Q000150:complications / Q000175:diagnosis