Medica Jadertina, Vol. 41 No. 3-4, 2011.
Izvorni znanstveni članak
Ultrasound-guided fine needle aspiration cytology of neck nodes
Branko Krišto
orcid.org/0000-0001-5533-2748
; Županijska bolnica Livno, Odjel za ORL i cervikofacijalnu kirurgiju, Bosna i Hercegovina
Marko Buljan
; Županijska bolnica Livno, Odjel za ORL i cervikofacijalnu kirurgiju, Livno, Bosna i Hercegovina
Sažetak
Introduction: Ultrasound-guided fine needle aspiration cytology in the diagnosis of neck nodes is a study of diagnostic accuracy which includes patients who have clinically presented themselves having neck nodes.
The study has been conducted in order to gain on objective evaluation of personal experiences in using this form of procedure.
Patients and methods: This research was done on a total of 180 patients, aged 6-89, about equally male and female (respectively 98 and 84). Neck ultrasonography was done on all patients and, after that, ultrasound-guided fine needle aspiration cytology. The results of fine needle aspiration cytology were compared with the referential („golden“) standard, histopathological report. Dependent of fine needle aspiration cytology diagnosis, the patients were retrospectively divided into two large groups. The first
group consisted of 98 patients whose cytologic diagnosis showed benign nodes; the second group was made up of patients with malignant nodes and they were further separated into two subgroups: patients with primary malignant nodes, made up a group of 25 patients, and those with secondary malignant nodes
(metastasis) on the neck, made up a group of 57 patients.
Results: Epidemiological analysis determined a much older age in patient groups of primary and secondary malignant nodes in relation to those patients having benign nodes. In the group of patients having
malignant nodes, both primary and secondary, men were more frequently present, (1.5:1 in favour of men), while their presence in the group with benign nodes was equal to that of women.
In groups of patients with malignant nodes, both primary and secondary, all diagnoses made by fine needle aspiration were confirmed by histopathologic diagnosis. In other groups suffering benign nodes determined by a fine needle aspiration, in 14 (14.2%) cases diagnosis was changed into malignant after histopathologic reports, but for the majority of patients the diagnosis remained unchanged. Reactive lymph node hyperplasia is the most frequent diagnosis determined by fine needle aspiration cytology, after which,
having done the histopathologic diagnosis, it was changed into malignant.
While analysing ultrasound-guided fine needle aspiration cytology on the whole, sensitivity of 92%, specificity 85.7% and accuracy 83.9% were determined with the group of patients with secondary malignant
nodes (metastasis) 90% sensivity, 73.8% specificity and 85.5% accuracy were determined.
Conclusion: Our results show that ultrasound-guided fine needle aspiration cytology is, with all its restrictions, a useful method in neck node diagnosis, and in many cases it can eliminate the need for excision biopsy and histopathological diagnosis. In cases when the need for other diagnostic proceedings is not excluded, it certainly sets the guidelines for further proceedings. The above mentioned results give us the right to confirm the exactness of the algorithm in which ultrasound-guided fine needle aspiration cytology is done after clinically affirmed neck nodes under ultrasound control, and the cytology is supposed to direct further diagnostic-therapeutical procedure.
Ključne riječi
Ultrasonography; fine needle aspiration citology; cervical nodes
Hrčak ID:
77256
URI
Datum izdavanja:
1.2.2012.
Posjeta: 16.402 *