Ultrasonographic Differentiation Between Metastatic and Benign Lymph Nodes in Patients With Papillary Thyroid Carcinoma

Rosário, Pedro Weslley; Faria, Sérgio de; Bicalho, Luciano Medeiros de Andrade; Alves, Maria Flávia Gatti; Borges, Mariane; Purisch, Saulo; Padrão, Eduardo L.; Rezende, Leonardo Lamego; Barroso, Álvaro Luís

doi:10.7863/jum.2005.24.10.1385

Cited by 269 publications

(172 citation statements)

References 21 publications

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“…Consequently, a positive FNAB-Tg in cystic CLNs may be a trigger for further clinical investigation of an occult PTC (9,21,22). It should be considered that cystic metastasis could also be encountered in tumours such head and neck and squamous cell carcinomas (9,23).…”

Section: Discussionmentioning

confidence: 99%

Thyroglobulin detection in fine-needle aspirates of cervical lymph nodes: a technique for the diagnosis of metastatic differentiated thyroid cancer

et al. 2007

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Background: Fine-needle aspiration cytology is frequently used for differential diagnosis of neck masses of unknown origin. Inconclusive and even false-negative results are not uncommon. Aim: To evaluate the utility of thyroglobulin (Tg) measurement in fine-needle aspirates (FNA-Tg) for detecting cervical lymph node (CLNs) metastases from differentiated thyroid carcinomas. Methods: An ultrasound-guided fine-needle aspiration was done in 67 patients with 83 suspicious enlarged CLNs to obtain material for cytology and Tg measurement in the needle washout, using an immunometric chemiluminescent assay. Measurement of anti-Tg antibodies (FNA-TgAb) was also carried out in half of all the aspirates. Subjects were divided into two groups: one of 16 patients awaiting thyroidectomy and the other of 51 patients in follow-up after surgery. Results: The first group of patients had positive FNA biopsy (FNAB-Tg) in 14 out of the 18 studied CLNs with a range of 3.2-43 352 ng/ml, while FNAB-cytology indicated metastasis in only 8 out of the 14 CLNs with positive histology. A total of 65 CLNs were studied in the follow-up group. Lymphadenectomy was performed in 23 patients and 28 aspirated CLNs were removed. Histology confirmed the diagnosis of metastasis suggested by FNAB-Tg in 20 CLNs and of reactive lymphadenitis in the remaining 8 CLNs. FNAB-cytology was positive in only 11 CLNs. Sensitivity of FNAB-Tg was not affected by the studied FNAB-TgAb. Conclusions: The FNAB-Tg achieved a sensitivity of 100% in both groups. FNAB-Tg is an easy and inexpensive technique which proved to increase the diagnostic of cytology in the early diagnosis of papillary carcinoma recurrence to CLN even in the presence of serum TgAb.

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Section: Discussionmentioning

confidence: 99%

Thyroglobulin detection in fine-needle aspirates of cervical lymph nodes: a technique for the diagnosis of metastatic differentiated thyroid cancer

et al. 2007

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“…Lymph nodes were characterized by US findings as highly suggestive of metastasis with any of following criteria: minor axis greater than 10 mm, short axis greater than 50% of long axis (change from oval to round shape), hyperechogenicity in relation to the adjacent muscles, absence of an echogenic hilum, microcalcifications, or intranodal cystic necrosis [8][9][10].…”

Section: Neck Ultrasonographymentioning

confidence: 99%

“…High-resolution cervical ultrasonography (US) has been reported to be the most sensitive method for differentiating between metastatic and benign lymph nodes in patients with PTC [8][9][10]. In patients with thyroid cancer, US can detect loco-regional metastatic disease as small as 2-3 mm in diameter [11,12], thus enabling the detection of metastatic lymph nodes missed by palpation alone in a significant proportion of patients with small macroscopic metastases [13].…”

Section: Introductionmentioning

confidence: 99%

Use of preoperative ultrasonography as guidance for neck dissection in patients with papillary thyroid carcinoma

Roh

Park

Kim

et al. 2008

Journal of Surgical Oncology

101

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Background: Preoperative neck ultrasonography (US) may detect nodal metastases of papillary thyroid carcinoma (PTC) but its utility in detecting metastases at specific neck subsites and levels is not known. We therefore evaluated preoperative US in detecting cervical metastases of PTC according to neck subsites and levels. Methods: Preoperative US was performed in 133 new patients to detect metastases at three central cervical subsites and five lateral cervical levels. All patients underwent total thyroidectomy and bilateral central neck dissection. Thirty-four patients with lateral nodal metastases underwent modified radical neck dissection. Results: Lymph node metastases to the central and lateral cervical compartments were identified in 57.9% and 25.6%, respectively. The sensitivity and specificity of US for detecting central nodal metastasis were 61.0% and 92.8%, respectively. In the lateral neck, US detected nonpalpable lymph node metastases in 6 of 34 patients (17.6%). Overall, US was >85.0% specific at all cervical subsites and levels. Conclusion: Preoperative US may detect cervical metastases of PTC and may assist in determining the necessity and extent of neck dissection in PTC patients.

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“…However, due to the overlapping two-dimensional images and dependence on subjective judgement of the examiner, standard criteria have yet to be developed for the diagnosis of benign and malignant nodules (Rosario et al, 2005;Tae et al, 2007).…”

Section: Quantitative Analysis Of Thyroid Blood Flow and Static Imagimentioning

confidence: 99%

Quantitative Analysis of Thyroid Blood Flow and Static Imaging in the Differential Diagnosis of Thyroid Nodules

Song

Zhang²,

Xiang³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Ultrasonographic Differentiation Between Metastatic and Benign Lymph Nodes in Patients With Papillary Thyroid Carcinoma

Abstract: Even basic ultrasonographic characteristics (shape, echogenicity and echogenic hilum, calcifications, and intranodal cystic necrosis) help in the differentiation between metastatic and nonmetastatic lymph nodes in patients with papillary thyroid carcinoma.

Cited by 269 publications

References 21 publications

Thyroglobulin detection in fine-needle aspirates of cervical lymph nodes: a technique for the diagnosis of metastatic differentiated thyroid cancer

Thyroglobulin detection in fine-needle aspirates of cervical lymph nodes: a technique for the diagnosis of metastatic differentiated thyroid cancer

Use of preoperative ultrasonography as guidance for neck dissection in patients with papillary thyroid carcinoma

Quantitative Analysis of Thyroid Blood Flow and Static Imaging in the Differential Diagnosis of Thyroid Nodules

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