Department of 1General Surgery and 2Pathology, National Medical Center, Seoul, Korea.
ABSTRACT
PURPOSE: This study was intended to evaluate the value of the FNAB in the diagnosis of the suspected metastatic cervical lymphadenopathy.
MATERIALS AND METHODS: 221 patients diagnosed as metastatic cervical lymphadenopathy by FNAB from Jan., 1990 to Oct., 1994 were analyzed retrospectively. They represented 92.1% of metstatic cervical lymphadenopathy managed and 15.7% of 1,411 FNAB's performed during the same period. 33 cases with lymphoma were excluded in this study.
RESULTS: In 107 patients with cervical lymphadenopathy who also received confirmatory node biopsy, the sensitivity, specificity, positive and negative predictive values of FNAB for the metastatic cervical lymphaenopathy were 79.3%, 100%, 100% and 44.1% respectively. In 76 (33.4%) patients the histopathologic types of the primary cancers were decided by information gained from FNAB alone. There were two kinds of tendency that GI cancers metastasized to left-sided cervical nodes (88.1%) and breast and lung cancers to ipsilateral supraclavicular nodes in high frequencies (94.1% and 86.8%, respectively). No complications were associated with FNAB.
CONCLUSION: FNAB is a simple, rapid, inexpensive and highly specific diagnostic tool in the evaluation of suspected metastatic cervical lymphadenopathy. The sensitivity and negative predictive value, however, are relatively low. When the clinical findings strongly suggest metastatic lymphadenopathy, the negative FNAB should be followed by confirmatory biopsy. Information gained from it guides further diagnostic and therapeutic plans. Surrounding normal tissues are not damaged, and the theoretical hazards of local implantation of tumor cells and complication are negligible.
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