Summary
This journal abstract evaluates the role of ultrasonic (US) examination in detecting cervical lymph node metastasis from head and neck cancer. The study involved 57 patients with carcinoma of the oral cavity, maxillary sinus, or oropharynx who underwent radical neck dissection. Preoperative US scans were compared to postoperative histopathological findings in lymph nodes (LNs) that were 5 mm or larger in diameter.
The study found that larger LNs on US scans had a higher histologically positive rate, with 96% of LNs measuring 15 mm or more being positive for metastasis. In contrast, flat LNs had a 95% negative rate. LNs with well-defined boundaries were more likely to be positive compared to those with poorly defined boundaries. However, the internal echo patterns (homogeneous, heterogeneous, and reflective core) did not significantly impact the positive rate. The research also noted that in six out of 57 patients, no LNs were detected by the US. Of these, four were true negatives, but two were false negatives.
In these two false-negative cases, histopathological examination revealed four LNs, two of which had extensive extranodal tumor spread and fibrosis due to previous radiotherapy. The study concludes that while it may be challenging to directly determine whether LNs are metastatic through the US, evaluating the size, shape, and boundary of the LN can enhance the positive rate. Ultrasound is considered an indispensable tool for diagnosing cervical lymph node metastasis in patients with malignant head and neck tumors.
