Cystic appearance of cervical lymph nodes is characteristic of metastatic papillary thyroid carcinoma

被引:94
作者
Kessler, A
Rappaport, Y
Blank, A
Marmor, S
Weiss, J
Graif, M
机构
[1] Tel Aviv Univ, Sackler Fac Med, Tel Aviv Sourasky Med Ctr, Dept Radiol,Ultrasound Dvi, IL-64239 Tel Aviv, Israel
[2] Tel Aviv Univ, Sackler Fac Med, Dept Otolaryngol, Tel Aviv Sourasky Med Ctr, IL-69978 Tel Aviv, Israel
[3] Tel Aviv Univ, Sackler Fac Med, Tel Aviv Sourasky Med Ctr, Dept Pathol,Cytol Div, IL-64239 Tel Aviv, Israel
关键词
cervical lymph node; papillary carcinoma of thyroid; high-resolution ultrasonography; cystic changes; fine needle aspiration; color Doppler ultrasonography;
D O I
10.1002/jcu.10130
中图分类号
O42 [声学];
学科分类号
070206 ; 082403 ;
摘要
Purpose. The usefulness of high-resolution sonography in diagnosing cervical lymph node metastases from papillary thyroid carcinoma was investigated. The accuracy of a particular sign, cystic change within a node, in establishing the diagnosis was assessed. Methods. The sonographic findings in 63 patients with enlarged cervical lymph nodes were retrospectively reviewed. The patients had undergone high-resolution gray-scale and color Doppler sonography followed by ultrasound-guided fine-needle aspiration (FNA) in all patients and surgical excision in 27 patients. Results. Abnormal sonographic features were present in the lymph nodes of all 63 patients. In 14 (70%) of 20 patients with papillary thyroid carcinoma, sonography depicted cystic changes. This pattern was not found in any of the other 43 patients, in whom FNA revealed either metastasis from another malignancy (22 patients) or benign reactive lymphadenopathy (21 patients). Among the 63 patients, there were 43 true-negative, 14 true-positive, 6 false-negative, and no false-positive results in the diagnosis of metastatic papillary thyroid carcinoma using the presence or absence of an intranodal cystic area on sonography. These results yielded a 70% sensitivity, 100% specificity, 100% positive predictive value, 88% negative predictive value, and 90% overall accuracy for this criterion. Conclusions. Cystic changes within a cervical lymph node are highly suggestive of metastatic papillary thyroid carcinoma. (C) 2002 Wiley Periodicals, Inc. J Clin Ultrasound 31:21-25, 2003; Published on line in Wiley InterScience (www.interscience.wiley. com). DOI: 10.1002/jcu.10130.
引用
收藏
页码:21 / 25
页数:5
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