The role of ultrasound and ultrasound-guided fine needle aspiration biopsy of lymph nodes in patients with skin tumours

  • Francesco Maria Solivetti
  • Fulvia Elia Struttura di Radiologia e Diagnostica per Immagini I.R.C.C.S . Istituto Dermosifilopatico di Santa Maria e San Gallicano - I.F.O. Istituti Fisioterapici Ospitalieri - Roma, Via Elio Chianesi, snc - 00144
  • Maria Giulia Santaguida Struttura di Radiologia e Diagnostica per Immagini I.R.C.C.S . Istituto Dermosifilopatico di Santa Maria e San Gallicano - I.F.O. Istituti Fisioterapici Ospitalieri - Roma, Via Elio Chianesi, snc - 00144 and "Sapienza" Università di Roma, Dpt Scienze Biotecnologie Medico-Chirurgiche, Latina, 04100
  • Antonino Guerrisi Struttura di Radiologia e Diagnostica per Immagini I.R.C.C.S . Istituto Dermosifilopatico di Santa Maria e San Gallicano - I.F.O. Istituti Fisioterapici Ospitalieri - Roma, Via Elio Chianesi, snc - 00144
  • Paolo Visca Struttura di Anatomia ed Istologia Patologica e Citodiagnostica, I.R.C.C.S. Istituto Regina Elena – I.F.O. Roma Via Elio Chianesi, snc - 00144
  • Maria Cecilia Cercato Epidemiologia. Istituto Regina Elena - I.F.O. Roma, Via Elio Chianesi, snc - 00144
  • Aldo Di Carlo Direzione Scientifica , I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano – I.F.O. Roma Via Elio Chianesi, snc - 00144

Abstract

Objectives The primary objective of this study is to evaluate US diagnostic accuracy in the study of superficial lymph nodes, during the follow-up of patients surgically treated for skin tumours. The secondary objective is to compare the positive cytological results with the histological report.

Methods From 2004 to 2011, 480 patients (M/F: 285/195; median age: 57 years; prevalent histotype: melanoma) underwent ultrasound-guided FNA of suspicious for recurrence lymph node. An expert radiologist performed US test of the lymph nodes, expressing either negative or positive report to the test, and then ultrasound-guided FNA examination. The FNA positive patients were subjected to lymphadenoctomy; the patients who tested negative were subjected to follow-up.

Results The lymph node dimensions were ≤ 2 cm in 90% of cases. Out of the 336 (70%) US “positive” patients, 231 were FNA positives; out of the 144 (30%) US “negatives”, 132 (91.7%) were FNA negatives; the sensitivity and specificity of the US were to 95% and 55.7%, respectively; the negative predictive value was 91.7% and the positive predictive value was 68.8%. In 97.5% of lymphadenoctomies the definitive histology has confirmed FNA positivity.

Conclusions Ultrasound is a sensitive method in the evaluation of superficial lymph nodes in the follow-up of patients with skin tumours; the false negatives are attributable to micro-metastases or partial colonizations. In the lymph nodes of smaller size the differential diagnosis between the structural alteration by phlogosis and the tumour is by no means easy (55.7% specificity). The elevated positive predictivity of cytology has been confirmed.

Author Biography

Maria Cecilia Cercato, Epidemiologia. Istituto Regina Elena - I.F.O. Roma, Via Elio Chianesi, snc - 00144
Published
2014-02-03
How to Cite
Solivetti, F. M., Elia, F., Santaguida, M. G., Guerrisi, A., Visca, P., Cercato, M. C., & Di Carlo, A. (2014). The role of ultrasound and ultrasound-guided fine needle aspiration biopsy of lymph nodes in patients with skin tumours. Radiology and Oncology, 48(1). Retrieved from https://www.radioloncol.com/index.php/ro/article/view/1821
Section
Radiology