Pattern of initial metastasis in the cervical lymph node from papillary thyroid carcinoma.
OBJECTIVE
This study attempted to reveal the pattern of initial lymphatic spread in order to investigate the clinical significances of lymph node metastasis in papillary thyroid carcinoma (PTC) since such information has yet to be elucidated in previous studies.


METHODS
This study reviewed 501 consecutive patients with PTC who had been surgically treated, accompanied by routine node dissection of the central, and lateral compartments. Thirty-eight cases were found to have only one metastatic node, and 62 cases were found to have 2 or 3 metastatic nodes. The locations of these metastatic nodes were mapped, and evaluated.


RESULTS
The initial lymph node metastasis occurred equally in the lateral and central compartments (19 vs. 19 nodes). Metastatic nodes were more frequently found in the central compartment (60 and 65 %) in cases with 2- and 3-node involvements. Twenty-two (60 %) and 33 (65 %) cases had at least one instance of lateral node involvement in those cases, respectively.


CONCLUSIONS
The current results demonstrated the pattern of initial lymphatic spread in PTC cases, and indicated the importance of evaluating the lateral nodes of at least compartments III and IV for accurate pathological staging, as well as for investigating the nature of the disease.
Department of Surgical Oncology, Osaka City University Graduate School of Medicine, 1-4-3, Ashahi-machi, Abeno-ku, Osaka 545-8585, Japan. nonoda@med.osaka-cu.ac.jp
Naoyoshi
N
Onoda
Tetsuro
T
Ishikawa
Hidemi
H
Kawajiri
Tsutomu
T
Takashima
Kosei
K
Hirakawa
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D002291:Carcinoma, Papillary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D037981:Neck Dissection; D009367:Neoplasm Staging; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy