Fine‐needle aspiration cytology predicts inguinal lymph node metastasis without antibiotic pretreatment in penile carcinoma

Abstract

palpable inguinal LNs at the time of penile biopsy. The sensitivity, specificity and accuracy of FNA cytology was compared with the histological findings from surgical LN clearance. RESULTSThe 25 FNAs were without complication and without evidence of implantation of metastasis in the needle tracts; 14 FNA samples were positive for metastasis, 10 were negative, and one was inconclusive. From the histological assessment of the surgical inguinal LN specimens, FNA cytology had a sensitivity of 93%, and specificity of 91% in predicting metastatic disease. CONCLUSIONFNA cytology of palpable inguinal lymphadenopathy before surgery for the primary tumour has a high sensitivity and specificity for metastatic penile cancer. This procedure permits early inguinal lymphadenectomy where appropriate without need for prolonged initial antibiotic treatment.

Sonography: An underutilized diagnostic tool in the assessment of metastatic groin nodes

“…Fine needle aspiration cytology (FNAC) has a sensitivity of 93% and a specificity of 91% in predicting metastatic disease. 8 However, it is difficult to select a lymph node for FNAC in the presence of multiple nodes due to nonspecific chronic lymphadenitis. Lymph node enlargement due to chronic nonspecific lymphadenitis is a common occurrence in a population of low socioeconomic status such as that in our study.…”

Current surgical management of penile cancer

“…32 Although in prior clinical practice, antibiotic therapy was given for 4-6 weeks to rule out LN enlargement from infectious or inflammatory conditions, current guidelines recommend FNA with ultrasound of suspicious nodes for an immediate diagnosis in clinically questionable cases (ie, with low-risk primary penile lesions). 47 In patients with clinically positive inguinal disease, radical ILND is recommended for complete surgical staging and treatment. Boundaries of dissection typically include the inguinal ligament and spermatic cord superiorly, the adductor longus muscle medially, and the sartorius muscle laterally (Fig 5).…”

Lymphadenektomie der Leisten- und Beckenregion

“…Bei klinisch verdächtigen, palpabel vergrößerten oder auch in bildgebenden Verfahren auffäl-ligen Lymphknoten besitzt die Feinnadelaspirationsbiopsie den Vorteil der minimalen Invasivität und wird in der Regel durch den interventionellen Radiologen durchgeführt [27]. Allerdings lassen sich manche Befunde wegen unzureichenden Materials nicht definitiv klä-ren.…”