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

Abstract

AbstractObjectives: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.