What is important for ultrasound evaluation of occult metastatic lymph nodes in laryngeal cancer: size, shape, vascularity or cytological findings?
The assessment of the status of the cervical lymph nodes in patients with a squamous cell carcinoma of the head and neck is still one of the most challenging diagnostic problems. We evaluated ultrasonography criteria with respect to their value for comparative determination of occult metastatic lymph nodes in laryngeal carcinoma. A prospective study was performed in 60 patients with laryngeal squamous cell carcinoma without enlarged neck nodes on CT scan. We used recommended sonography criteria for size, shape and vascularity for distinguishing metastatic and nonmetastatic nodes preoperatively and compared them with cytological and histopathological investigations. Fifty-two of 144 lymph nodes were involved with metastasis on histopathological examination. Respective values for ultrasound-guided fine needle aspiration cytology (USg FNAC) showed high sensitivity, specificity, positive and negative predictive values and accuracy (92, 100, 100, 96, and 97%, respectively). The size, shape and vascularity showed significantly lower values of these statistic parameters. USg FNAC is useful for preoperative evaluation of the neck, as the most reliable, inexpensive and easily available method. It is essential for diagnosis, staging and therapy choices.
Cvorović
L
L
Department of Otorhinolaryngology, University Hospital Zemun, Belgrade, Serbia. ljiljanamil@sezampro.yu
Milutinović
Z
Z
Strbac
M
M
Markovski
S
S
D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002294:Carcinoma, Squamous Cell / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D005189:False Positive Reactions; D005260:Female; D005931:Glottis / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007822:Laryngeal Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000000981:diagnostic imaging* / Q000473:pathology*; D009382:Neoplasms, Unknown Primary / Q000098:blood supply / Q000473:pathology / Q000648:ultrastructure; D011446:Prospective Studies; D014463:Ultrasonography