Ultrasound-Guided Needle Procedures in the Diagnosis of Malignant Cervical Lymph Nodes

Wu-Chia Lo ； Po-Wen Cheng ； Li-Jen Liao

《International Journal of Head and Neck Science》 2卷1期 (2018/03) Pp. 35-41

https://doi.org/10.6696/IJHNS.201803_2(1).0006

摘要

Background: The aim of this study is to evaluate our experience performing ultrasound-guided fine needle aspiration (US-FNA) and ultrasound-guided core needle biopsy (US-CNB) in different kinds of malignant cervical lymphadenopathies. Methods: From July 2012 to December 2013, ultrasonographic features and US-guided needle procedures of consecutive 116 patients who had fi nal diagnoses of malignant cervical lymphadenopathies were retrospectively reviewed. They were divided into two populations, including 35 treated patients who had received complete treatment of previous carcinoma, and 81 untreated patients without any history of malignancy. Results: In treated patients (n = 35), the US-FNA results were positive or suspicious for metastatic carcinoma in 34 (97%) patients. In untreated patients (n = 81), the false negative rate of US-FNA results in lymphomatous nodes (LYM group) was significantly higher than those in metastatic nodes from papillary thyroid carcinoma (PAP group) and nonthyroid primary carcinoma (META group) (p ＜ 0.01). In terms of the time period from initial needle puncture to fi nal diagnosis, the patient in LYM group who received US-FNA as his initial procedure had the longest time period (73.2 ± 31.5 days) among the study groups (p ＜ 0.01, log-rank test). As to US characteristics, the node of LYM group was larger and less round shape than the other two groups. Conclusions: Patients' history and sonographic features could help us to decide either US-FNA or USCNB should be performed. US-FNA with selective use of US-CNB is an appropriate approach in the assessment of malignant cervical lymphadenopathies.

關鍵字

malignant cervical lymphadenopathy ； core-needle biopsy ； fine-needle aspiration ； ultrasonography ； metastatic node