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Role of ultrasound-guided fine needle aspiration in assessing the impalpable cervical node with increased 18F-fluorodeoxyglucose uptake on positron emission tomography scanning: preliminary communication

Published online by Cambridge University Press:  13 June 2008

C-P Wang ,
C-Y Lee ,
P-J Lou ,
R-F Yen ,
J-K Hsiao  and
J-Y Ko
C-P Wang
Affiliation:
Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
C-Y Lee
Affiliation:
Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
P-J Lou
Affiliation:
Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
R-F Yen
Affiliation:
Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
J-K Hsiao
Affiliation:
Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
J-Y Ko*
Affiliation:
Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
*
Address for correspondence: Dr Jenq-Yuh Ko, Department of Otolaryngology, National Taiwan University Hospital, 7 Chung-Shan South Rd, Taipei, Taiwan. Fax: +886 2 23410905 E-mail: [email protected]
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Abstract

Objectives:

18F-Fluorodeoxyglucose positron emission tomography can detect cervical metastases before they are palpable. However, false positive results are not uncommon. This paper reports the use of ultrasound-guided fine needle aspiration to determine the nature of impalpable cervical nodes that are positive on positron emission tomography scanning.

Methods:

Ultrasound-guided fine needle aspiration was performed in 10 cancer patients with suspicious cervical nodes revealed by positron emission tomography scan. Clinical data were retrospectively reviewed.

Results:

The underlying cancers included lung cancer (three patients), nasopharyngeal carcinoma (two), oesophageal cancer (two), buccal cancer (one), bladder cancer (one) and Langerhan's histiocytosis (one). The lymph nodes were located in the supraclavicular region in four patients, the level II region in four, the level IV region in one and the accessory chain in one. Cytological examination was positive for malignant cells in eight patients, all of whom received salvage treatment. Two of these patients died of distant metastases. Cytological examination revealed a benign or reactive lesion in two patients, who at the time of writing were alive and well, 19 and 36 months after examination.

Conclusions:

Ultrasound-guided fine needle aspiration is a minimally invasive procedure which enables cytological examination of suspicious cervical lymph nodes detected by positron emission tomography scanning, allowing further treatment to be planned.

Keywords

Positron Emission TomographyHead and Neck NeoplasmsNeoplasm MetastasisUltrasoundNeedle Biopsy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 12 , December 2008 , pp. 1349 - 1353
Copyright
Copyright © JLO (1984) Limited 2008

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