Clinicopathological Profile of Metastatic Cervical Lymph Nodes- A Descriptive Study in a Tertiary Care Centre (original) (raw)
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Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2007
The cervical lymphadenopathy due to metastasis carry poor prognosis. The status of cervical nodes is of critical interest to surgical, radiation and medical oncologists who manage patients with head and neck cancers. We conducted a prospective randomized study to assess the role of palpation, ultrasound and CT in detection of cervical metastasis in 25 patients presented to us with head and neck malignancy irrespective of cervical nodal status. It was observed that clinical examination was least sensitive (73.33%) when compared with computerized tomography (80%) and ultrasound (93.93%). The computerized tomography was found to be most specific (90%) when compared to clinical examination or ultrasonography (70% each).
Patterns of Neck Node Metastasis in Carcinoma of Oral Cavity
Bangladesh Journal of Otorhinolaryngology, 2020
Objectives: To find out the patterns of cervical lymph node metastasis in oral cavity carcinoma. Methods: This is across sectional study which was carried out in the department of Otolaryngology & Head Neck Surgery Dhaka Medical College Hospital (DMCH), Sir Salimullah Medical College Hospital (SSMC), Bangabandhu Sheikh Mujib Medical University (BSMMU) and National Institute of Cancer Research & Hospital (NICRH) from July 2013 to December 2014.Total 96 cases were included in this study. Data were collected by detail history, clinical examination, relevant investigation and result were processed manually and analyzed with the help of SPSS. Results: In this study 72 (75%) patients presented with clinically palpable neck nodes and 24 (25%) presented without neck node. Among 24 cases 7 cases was radiologically positive neck node. Out of 96 cases stage III was the highest (50.96%) followed by stage IV (27.01%), stage II (13.52%) and stage I (8.32%). That is 23 (23.92%) patients present wi...
Lymph nodes assessment of neck in oral squamous cell carcinoma and its implication in management
International Journal of Applied Dental Sciences, 2020
Background and Aim: This study was conducted to find the correlation between clinically palpable neck nodes and their histopathological examination results which gives some information to the clinician regarding the choice of treatment and for appropriate management of the neck. After the surgical procedure, the whole specimen was submitted for the histopathological examination and a correlation between clinical positive or negative nodes and their histologically confirmed malignancies were drawn. Materials & Methods: A total of 200 patients with the diagnosis of oral malignancy subjected to oral and maxillofacial surgery department and institute of oncology over the period of 2 years were included in the study. Once the confirmation by histopathology was done, routine blood investigation, HIV/HBSAg test, ECG was done and physician's consent was taken prior to surgery under general anaesthesia. Pre-operatively thorough clinical palpation of the five levels of cervical lymph nodes was performed bilaterally. Results: On clinical examination of lymph nodes by palpation in 200 cases, 50 sides of necks were negative for palpation and 162 sides of necks were positive for palpation. On the histopathological examination of neck dissections, 8 of necks were positive. That is 46 cases were true positive that the histopathology showed no metastasis and 8 cases were false positive which showed metastasis in histopathology. Conclusion: Histopathology examination with its ability to detect 100% metastases in cervical lymph nodes remains the gold standard. Even though, Clinical examination was and is still the routine first line in detecting cervical lymph node metastases in head and neck squamous cell carcinoma, Its use shall be restricted for only an initial evaluation of the patient.
A Study on Secondary Neck Nodes from Squamous Cell Carcinoma of the Head and Neck Region
AIM: To find out the incidence of cervical node metastases on clinical examination in squamous cell carcinoma of the head and neck region. To find the incidence of cervical nodal metastases commonly involved according to the primary tumour at the time of presentation. To describe the distribution of cervical node metastases by the site of the primary tumour. To correlate individually the size of the tumour and cervical nodal metastases. To correlate individually the degree of histopathological differentiation of tumour and cervical nodal metastases. METHODS: The materials used in the study consisted of 60 cases of histologically proven squamous cell carcinoma in the head and neck region which were admitted in all surgical wards of Government Mohan Kumaramangalam Medical College and Hospital, Salem during June 2018-June 2020. RESULTS: Males are predominantly affected by squamous cell carcinoma of head and neck region. 75% of patients had nodal metastasis at the time of admission. Posteriorly situated tumours displayed greater propensity of nodal metastases than anteriorly situated tumours. Carcinoma arising in the buccal mucosa, alveolus, floor of mouth, hard palate and maxillary antrum predominantly metastasized to the submandibular nodes, whereas those arising in the tongue (both anterior 2/3rd and posterior 1/3rd), tonsils and soft palate predominantly metastasized to the upper deep cervical group. A progressive increase in the incidence of node metastases was observed with increasing tumour size. A progressive increase in the incidence of node metastasis was observed with increasing histological undifferentiation of the tumour. CONCLUSION: Males are predominantly affected by squamous cell carcinoma of head and neck region. 75% of patients had nodal metastasis at the time of admission Site of the primary appeared to influence the incidence of regional nodal metastases. Posteriorly situated tumours arising in the oropharynx (base of tongue, tonsils, soft palate) displayed a greater propensity for regional metastases(66% to 100%) as compared to anteriorly situated tumours arising in the oral cavity(33% to 83%). Amongst the posteriorly situated tumours, carcinoma of the tonsils showed the highest incidence of nodal metastases(100 percent). Amongst the anteriorly situated tumours, carcinoma of buccal mucosa showed the highest incidence of node metastases (83.33%). The large primaries (more than 4cm) and those with higher histologic grade (moderate to poorly differentiated) have a greater propensity for developing regional nodal metastasis.
British Journal of Oral and Maxillofacial Surgery, 2020
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A_ study wa1 conducted on the value of Ultra\Ound (US) in the detectton of cavical lymph node metavtave1 in cave~ of Head and 1Veck 111altgna11cy; and it1 11,1ejul11ess in planning surgical management. The climcal, ultra10nograplt1c and lmtopathological e.wmmatio11 (HPE) findingv were compared in 20 patient; a1 a preliminary aHes1ment of thi1 ongoing 1tudy. Clmical/y aud ultrmo1wg1 aplzically, patient, were a>1e11ed for pre1e11ce of nodes, their size, shape, mobility and overall pm,it1v1ty for maliguanly. All patient, then underwent neck dissection, and i11dfl'idual node1 from the 1peeime111 were a11e11ed by HPL It wa1 found that US, when compared ;;zth elinical examination had a 1ensitivity of 47.62% versus 43. 75%, specificity of 77.78'7c ver1u1 25.0'lc and an accuracy of 6l.54C/c a1 opposed to 38.9%. US proved valuable in detecting sub-clznical node1, central necro,i,. cctra-capsular spread, pressure on large vessels • all indicators of' meta.italic 1pread. Hence, US wa1 found to be efficient and costeffective pre-operatively, in planning 1urgical management.
CODS Journal of Dentistry
reconstructive surgery metastasis misprediction, clinically and radiologically. There was a lack of distant metastasis from the primary, in all the 30 cases included in the study, as supported by normal CXR and ultrasonography of the liver and suprarenal glands. Conclusion: To conclude, there exists a positive correlation between the degree of histopathological malignancy and cervical metastasis in head and neck SCC. The tendency toward tumor overstaging and cervical metastasis misprediction clinically and radiologically can be overcome; whether the type of neck dissection performed is warranted or not and the probable prognosis can also be determined, by and large; all these strongly supports the fact that histopathology still serves universally as the gold standard!!
Metastatic squamous cell carcinoma to cervical lymph nodes from unknown primary mucosal sites
Head & Neck, 1994
Between 1978 and 1991, 54 patients with metastatic squamous cell or undifferentiated carcinoma to the cervical lymph nodes, with unknown primary mucosal sites, were treated with curative intent at McGill University teaching hospitals. The median age at diagnosis was 58 years with a male:female ratio of 6:l. All patients presented with a painless neck mass. Five patients (9%) presented with N1 disease, 28 (52%) with N2a disease, four (7%) with N2b disease, three (6%) with N2c disease, and 14 (26%) with N3 disease. Twentyfour patients (44%) underwent neck dissection, and 30 (56%) had only excisional lymph node biopsy. Fifty-three patients (98%) were treated with radiotherapy to a median dose of 60 Gy (range 38 to 66 Gy) in 30 fractions. With a median followup time of 49 months, the overall actuarial survival was 63% and 59% at 5 and 10 years, respectively. Three patients were found to have a subsequent primary head and neck tumor. The single most important prognostic factor was the N stage, which influences both neck control and long-term survival. There was no statistically significance difference in survival or local neck control rates between patients who had neck dissection or excisional lymph node biopsy (p > 0.05).
2014
Introduction: Squamous cell carcinoma represents about 90% of malignancies of the mouth and about 38% of the head and neck tumors. The behavior of the cancer is very aggressive, presenting early cervical metastasis and, often contralateral ranging from 0.9 to 36%. Objectives: This study aims to analyze clinical and pathological factors that may influence metastasis of squamous cell carcinoma in cervical lymph nodes and relate this occurrence in the contralateral primary tumor, with disease prognosis and the interference of this type of metastasis in the survival rate of patients with this pathology. Material and Metohds: It was conducted a retrospective study from medical records of patients with Squamous Cell Carcinomas with homolateral lymph node metastasis and contralateral attended at the clinic of Head and neck surgery of Hospital São Vicente de Paulo in Passo Fundo -RS -Brazil, from 2000 to 2008. Results: Analyzing the charts of patients with metastatic and metastatic contralateral side it was observed that patients with initial stage presented a higher survival with statistical significance (p=0,035). Conclusions: The occurrence of metastases in lymph nodes of contralateral position to the primary lesion was not the main fator that influenced the survival of the group.