Nonpalpable lymph nodes of the neck: Assessment with US and US-guided fine-needle aspiration biopsy

Abstract

Ultrasound (US) and US‐guided fine‐needle aspiration biopsy (FNA) were performed in 91 nonpalpable neck nodes of 70 patients, 93% of which had known malignancy. Various sonographic findings were evaluated for predicting malignancy. The accuracy of US‐guided FNA for detecting malignancy was 88%, with 96% sensitivity and 94% specificity. The ratio of minimal to maximal axial diameters of a node was most valid for predicting malignancy with US. A ratio of more than 0.55 yielded the highest accuracy (80%) (92% sensitivity, 63% specificity). Addition of any other factors to this criterion did not improve its accuracy. US and US‐guided FNA are accurate for the assessment of nonpalpable neck nodes. Lymph nodes with a round configuration should be biopsied in patients with known malignancy. © 1997 John Wiley & Sons, Inc. J Clin Ultrasound 25:283–292, 1997

Sonographically guided lymph node biopsy: Complication rates

“…It served to exclude or confirm the diagnosis in patients with enlarged lymph nodes and is of decisive clinical value in determining therapy and prognosis [3][4][5]. Despite real-time imaging and pre-interventional assessment of the planned puncture path, complications may very infrequently occur.…”

“…In the literature, reported rates are low, ranging from 0 to 2.9% [1][2][3][4][5][6][7][8][9][10] ( Table 1). Major complications were reported in two publications, both secondary to vascular injuries [3,6]. The available studies, however, concentrated on the outcome of the punctures; complications were addressed more as a secondary issue that, in some cases, was not specifically discussed [11,12].…”

“…Platelet count was documented in 41.6% (n = 223) of the PP and was below the limit of ≥70,000/µl in 4.5% (n = 10); the lowest platelet count was 11,000/µl. Quick's value [3,6]. Because there were no complications reported in the present study, it was not possible to show an increased risk of complications for the potential risk factors of number of punctures, the number of passes, the localization, diameter of the lymph node (s), puncture technique, needle gauge, as well as patients' sex, age and coagulation parameters, and the experience of the examiner.…”

“…Because there were no complications reported in the present study, it was not possible to show an increased risk of complications for the potential risk factors of number of punctures, the number of passes, the localization, diameter of the lymph node (s), puncture technique, needle gauge, as well as patients' sex, age and coagulation parameters, and the experience of the examiner. To our knowledge, no other study has included an analysis of this type, which, because of the often small number of punctures and complications, is not always feasible [1,3,6].…”

“…Despite real-time imaging and pre-interventional assessment of the planned puncture path, complications may very infrequently occur. Complication rates in the literature are in the range of 0% -2.9% [1][2][3]6]. To our knowledge, however, no large studies have addressed the causes of complications in patients undergoing sonographically guided diagnostic lymph node biopsy.…”