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Vojnosanitetski pregled 2005 Volume 62, Issue 12, Pages: 901-907
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Significance of ultrasound and ultrasound-guided fine-needle aspiration for the detection of laryngeal occult metastases

Čvorović Ljiljana, Milutinović Zoran, Štrbac Mile, Pavićević Ljubomir, Račić Alek J.

Background/Aim. To evaluate ultrasound criteria based on a node size, shape, vascularity and cytology findings with respect to their value for the comparative determination of metastatic lymph nodes in laryngeal carcinoma. Methods. A prospective study included 30 patients with laryngeal squamous cell carcinoma without node enlargement on computerized tomography, at the Department of Otorhinolaryngology, the University Hospital, Zemun. Thirty-six neck lymph nodes were evaluated sonographically and aspirated with an ultrasound-guided fine-needle. They were examined cytologically and/or histopathologically and compared to the sonographic assessment of their malignancy. Results. Of the 36 neck lymph nodes evaluated cytologically, the 13 were found to be with a metastatic deposit. The assessment of a lymph node malignancy using the parameter of size had the sensitivity of 84%, the specificity of 70%, and the reliability of 75%. Using the criteria of a lymph node shape for the assessment of malignancy, the sensitivity of 61%, specificity of 65%, and the reliability of 64% were achieved. The evaluation of a lymph node vascularity by the use of the effect of Doppler showed the sensitivity of 69%, the specificity of 95%, and the reliability of 86%. Concluson. Ultrasound and ultrasound-guided fine-needle aspiration cytology should be always used for the preoperative staging and for the postoperative follow-up of the status of the neck with cancer of the larynx becouse of their high accuracy, availability and semiinvasivity, and in order to enhance the reliability of the evaluation of the malignant disease progression.

Keywords: laryngeal neoplasms, lymphatic metastasis, ultrasonography, biopsy, fine-needle, histocytochemistry, sensitivity and specificity

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