Usefulness of narrow-band imaging for detecting the primary tumor site in patients with primary unknown cervical lymph node metastasis.
OBJECTIVE
We sometimes experienced patients with primary unknown cervical lymph node metastasis. In such cases, if computed tomography, magnetic resonance imaging, laryngoscopy and gastrointestinal endoscopy cannot detect a primary site, there is no other effective method to identify a possible primary tumor. We investigated whether narrow-band imaging can detect a possible primary tumor in such.


METHODS
Forty-six patients with primary unknown cervical lymph node metastasis were surveyed about primary tumors, from January 2003 to December 2006. All cervical lymph nodes were histologically proved to be squamous cell carcinoma by fine-needle aspiration cytology. Narrow-band imaging combined with magnifying endoscopy was used to identify the primary site in the head and neck region and cervical esophagus. Histological analysis was performed for all suspicious lesions by a biopsy specimen.


RESULTS
Twenty-six lesions were suspected to be cancerous lesions by narrow-band imaging in the head and neck region. Sixteen lesions in 16 (35%, 16/46) patients were squamous cell carcinoma. Ten lesions were located in the hypopharynx and the remaining six lesions were located in the oropharynx. White light endoscopy could not point out any lesion.


CONCLUSIONS
Narrow-band imaging endoscopy can detect possible primary cancer in patients with primary unknown cervical lymph node metastasis.
Department of Head and Neck Surgery, Kyoundo Hospital Sasaki Foundation, Tokyo, Japan. hayashi@po.kyoundo.jp
Tomomasa
T
Hayashi
Manabu
M
Muto
Ryuichi
R
Hayashi
Keiko
K
Minashi
Tomonori
T
Yano
Seiji
S
Kishimoto
Satoshi
S
Ebihara
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000628:therapy; D003131:Combined Modality Therapy; D004724:Endoscopy; D005260:Female; D006801:Humans; D007089:Image Enhancement; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis* / Q000628:therapy