Abstract
Objective: We aimed to characterize sonographic findings of various malignant cervical lymphdenopathy (MCL) and to compare the effectiveness between ultrasound-guided fine-needle aspiration(US-FNA) and core-needle biopsy (US-CNB) in achieving their diagnosis.
Method: A total of 113 MCL patients, receiving real-time US-FNA or US-CNB, were rectrospectively reviewed from July 2007 to Dec 2011. Results of FNA cytology and CNB pathology were categorized as being false negative, suspicous, and positive for malignancy. The US features, time from needle biopsy to diagnosis were also recorded and compared statistically.
Results: The US-FNA with false-negative rate 50% (7/14) for lymphomatous nodes (LYM) was significantly higher than those of nonthyroid primary carcinoma (META; 0%; 0/60), papillary thyroid carcinoma (PAP; 8.3%;1/12), and US-CNB for LYM (0%; 0/13) and META (0%;0/14). Comparing time from needle procedure to diagnosis among META-FNA, LYM-FNA, PAP-FNA, META-CNB, and LYM-CNB, US-FNA had the longest time to diagnosis (P < .01, Log-rank test). Discriminating US indicators included internal echo, S-axis/L-axis ratio, hilar echogenicity, calcification, and cystic formation.
Conclusion: Sonographic finding are valuable for MCL diagnosis and in deciding whether US-FNA or US-CNB should be done. US-FNA can be a diagnostic tool for most MCL. US-CNB, however, should be performed if malignant lymphoma is suspected.
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