title: [Thyroglobulin concentration measurement in fine-needle aspiration fluid from cystic cervical lymph node metastases of papillary thyroid carcinoma].
abstract: BACKGROUND
  Combining ultrasonography, computed tomography (CT), magnetic resonance imaging (MRI) and fine-needle aspiration cytology (FNAC) usually results in the best preoperative diagnosis of cervical masses, including neoplasms. This may not be true, however, especially in occult papillary thyroid carcinoma (PTC) associated with single cystic cervical lymph node metastasis. We assessed the role of thyroglobulin measurement in FNA fluid (FNATg) in differentially diagnosing cystic cervical mass lesions, including PTC cystic lymph node metastasis.
  
  
  METHODS
  We reviewed the records of 17 subjects with cervical cystic masses undergoing both FNATg measurement and surgery. FNA was done under ultrasonographic guidance. We also measured FNATg concentrations from extrathyroid lesions, consisting of cystic cervical lymph node metastases and benign cystic lesions.
  
  
  RESULTS
  Pathological diagnosis involved 5 PTC lymph node metastases, 3 lateral cervical cysts, 7 thyroglossal duct cysts, and 2 squamous cell carcinoma (lung and oropharynx) lymph node metastases. FNATg of PTC lymph node metastasis was much higher than the reference range of blood serum thyroglobulin, although much lower for the lateral cervical cyst detection threshold. FNAC and FNATg measurement are thought to be mutually complementary in the differential diagnosis of PTC cystic lymph node metastasis.
  
  
  CONCLUSIONS
  High concentrations of FNATg in a cystic cervical mass is considered specific to PTC lymph node metastasis, indicating its usefulness in distinguish PTC cystic metastasis from other cystic lesions. Including FNATg measurement with FNAC may thus improve preoperative diagnosis accuracy without additionally stressing subjects with PTC cystic lymph node metastasis.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Keio University, Tokyo.
authors.forename: Yozo
authors.initials: Y
authors.lastname: Inagaki
authors.forename: Koji
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Imanishi
authors.forename: Toshiki
authors.initials: T
authors.lastname: Tomita
authors.forename: Seiichi
authors.initials: S
authors.lastname: Shinden
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ozawa
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Fujii
authors.forename: Seiji
authors.initials: S
authors.lastname: Shigetomi
authors.forename: Takahisa
authors.initials: T
authors.lastname: Watabe
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamada
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle; D002277:Carcinoma; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009333:Neck; D013954:Thyroglobulin / Q000032:analysis*; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology*
chemical_list: D013954:Thyroglobulin