title: Quantification of lymph nodes in the central compartment of the neck: a cadaveric study.
abstract: Differentiated thyroid cancer (DTC) accounts for over 90 % of thyroid malignancies, and is frequently associated with central neck compartment nodal metastasis that requires a therapeutic central compartment neck dissection (CCND) for clinically evident nodes. Current knowledge on the expected lymph node yield from a CCND is limited, compared with data on the lateral neck. The aim of our study was to accurately quantify nodal yield from the cadaveric central neck compartment. Twenty-eight cadaveric necks were dissected and the central neck compartment was subdivided into four regions: pre-laryngeal (delphian), pre-tracheal, right and left para-tracheal regions. Each cadaver had a thyroid gland, which was also removed, and the CCND tissue in each compartment was processed and examined by a consultant histopathologist. Only lymphoid tissue with a defined microscopic fibrous capsule and subcapsular sinus was included in the node count. The median total lymph node count per cadaver was four (range 1-16), with a median of one node detectable in each para-tracheal region (range 0-7) and the pre-tracheal region (range 0-8). The median pre-laryngeal node count was 0 (range 0- 2). The average lymph node size across all compartments was 2.9 mm. This is the first European study to assess cadaveric central neck lymph nodes and establish baseline counts for nodal yield. If a prophylactic or therapeutic CCND is required during thyroid surgery, those involved in DTC management must recognise that there is a wide range, and low median yield of central neck compartment lymph nodes.
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, United Kingdom. eofo@hotmail.com.
authors.forename: Enyinnaya
authors.initials: E
authors.lastname: Ofo
authors.affiliation: Department of Head and Neck Pathology, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, United Kingdom.
authors.forename: Selvam
authors.initials: S
authors.lastname: Thavaraj
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, United Kingdom.
authors.forename: Daron
authors.initials: D
authors.lastname: Cope
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Barr
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, United Kingdom.
authors.forename: Karan
authors.initials: K
authors.lastname: Kapoor
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, United Kingdom.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Jeannon
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Oakley
authors.affiliation: Department of Head and Neck Pathology, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, United Kingdom.
authors.forename: Claire
authors.initials: C
authors.lastname: Lock
authors.affiliation: Department of Head and Neck Pathology, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, United Kingdom.
authors.forename: Edward
authors.initials: E
authors.lastname: Odell
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RT, United Kingdom.
authors.forename: Ricard
authors.initials: R
authors.lastname: Simo
mesh_terms: D000369:Aged, 80 and over; D002102:Cadaver; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D009333:Neck; D037981:Neck Dissection; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery; D013965:Thyroidectomy
keywords: Cadaver; Central neck dissection; Lymph node yield; Pathology; Thyroid cancer; Thyroidectomy