title: The role of ultrasound and ultrasound-guided fine needle aspiration biopsy of lymph nodes in patients with skin tumours.
abstract: BACKGROUND
  The primary aim of this study was to evaluate the diagnostic accuracy of ultrasound (US) in the study of superficial lymph nodes during the follow-up of patients surgically treated for skin tumours. The secondary objective was to compare positive cytological results with histological reports.
  
  
  METHODS
  From 2004 to 2011, 480 patients (male/female: 285/195; median age 57 years; prevalent skin tumour: melanoma) underwent US-guided fine-needle aspiration biopsy (FNAB) of suspicious recurrent lymph nodes. An expert radiologist first performed US testing of the lymph nodes, expressing either a negative or positive outcome of the test. Subsequently, US-guided FNAB was performed. FNAB positive patients were subjected to lymphadenectomy; the patients who tested negative underwent the follow-up.
  
  
  RESULTS
  The size of lymph nodes was ≤ 2 cm in 90% of cases. Out of the 336 (70%) US "positive" patients, 231 (68.8%) were FNAB positives. Out of the 144 (30%) US "negatives", 132 (91.7%) were FNAB negatives. The sensitivity and specificity of the US were 95% and 55.7%, respectively; the negative predictive value was 91.7% and the positive predictive value was 68.8%. Definitive histological results confirmed FNAB positivity in 97.5% of lymphadenectomies.
  
  
  CONCLUSIONS
  US is a sensitive method in the evaluation of superficial lymph nodes during the follow-up of patients with skin tumours. High positive predictive value of cytology was confirmed.
authors.affiliation: Radiologia e Diagnostica per Immagini, I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano, Rome, Italy.
authors.forename: Francesco Maria
authors.initials: FM
authors.lastname: Solivetti
authors.affiliation: Radiologia e Diagnostica per Immagini, I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano, Rome, Italy.
authors.forename: Fulvia
authors.initials: F
authors.lastname: Elia
authors.affiliation: Radiologia e Diagnostica per Immagini, I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano, Rome, Italy ; Sapienza Università di Roma, Dpt. Scienze Biotecnologie Medico-Chirurgiche, Rome, Italy.
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Santaguida
authors.affiliation: Radiologia e Diagnostica per Immagini, I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano, Rome, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Guerrisi
authors.affiliation: Struttura di Anatomia ed Istologia Patologica e Citodiagnostica, I.R.C.C.S. Istituto Regina Elena, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Visca
authors.affiliation: Epidemiologia, Istituto Regina Elena, Rome, Italy.
authors.forename: Maria Cecilia
authors.initials: MC
authors.lastname: Cercato
authors.affiliation: Direzione Scientifica, I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano, Rome, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Di Carlo
keywords: fine needle aspiration biopsy, follow-up; skin tumours; ultrasound