title: Usefulness and pitfall of Narrow band imaging combined with magnifying endoscopy for detecting an unknown head and neck primary site with cervical lymph node metastasis.
abstract: OBJECTIVE
  Cervical nodal metastasis from clinically undetectable primary squamous cell carcinoma (SCC) accounts for 1-2% of head and neck malignancies. We retrospectively evaluate the ability of Narrow band imaging combined with magnifying endoscopy (NBI-ME) to detect the primary sites of superficial SCC in the head and neck region.
  
  
  METHODS
  This was a report of 11 patients. We performed with NBI-ME to detect unknown primary sites in the head and neck.
  
  
  RESULTS
  Among 11 patients, primary sites were detected in eight. Primary sites were detected in the head and neck in 6 (54.5%) of 11 patients on NBI-ME, all 6 primary lesions were a flat lesion. Two patients in whom primary lesions could not be detected on NBI-ME, one had submucosal tumor like lesion, the other featured by a detectable primary lesion 19 months after neck dissection.
  
  
  CONCLUSIONS
  NBI-ME can be recommended as an essential procedure for the detection of primary lesions in patients with primary unknown cervical lymph node metastasis.
authors.affiliation: Department of Otorhinolaryngology, Kitasato University School of Medicine, Sagamihara, Japan. tamasaki@med.kitasato-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Masaki
authors.forename: Chikatoshi
authors.initials: C
authors.lastname: Katada
authors.forename: Meijin
authors.initials: M
authors.lastname: Nakayama
authors.forename: Masahiko
authors.initials: M
authors.lastname: Takeda
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Yutomo
authors.initials: Y
authors.lastname: Seino
authors.forename: Hiroki
authors.initials: H
authors.lastname: Matsuba
authors.forename: Tabito
authors.initials: T
authors.lastname: Okamoto
authors.forename: Wasaburo
authors.initials: W
authors.lastname: Koizumi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tanabe
authors.forename: Satoshi
authors.initials: S
authors.lastname: Horiguchi
authors.forename: Makito
authors.initials: M
authors.lastname: Okamoto
authors.forename: Manabu
authors.initials: M
authors.lastname: Muto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009333:Neck; D009382:Neoplasms, Unknown Primary / Q000175:diagnosis*; D012189:Retrospective Studies