AI Article Synopsis

  • The study aims to demonstrate the effectiveness of ultrasonography in diagnosing cervical lymphadenopathy associated with oral cancers and to determine if it provides valuable information before lymph node biopsies.
  • Twenty patients with confirmed oral malignancies and palpable lymph nodes underwent both clinical and ultrasonographic examinations, followed by histological assessment post-excision.
  • Results showed ultrasonography was more effective than clinical exams, identifying additional lymph nodes and displaying high sensitivity (90%) and specificity (100%) for malignant features, particularly the loss of echogenic hilus and intranodal necrosis.

Article Abstract

Aims And Objectives: To substantiate the use of ultrasonography in diagnosis of cervical lymphadenopathy in oral malignancies and to assess if ultrasonographic examination done prior to lymph node (LN) biopsy can yield important information regarding the diagnosis.

Materials And Methods: Twenty subjects with histopathologically confirmed oral malignant lesions with clinically palpable and untreated cervical LNs included into study. These patients were subjected to clinical examination (number of LNs, shape, size, location, overlying temperature, overlying skin, tenderness, consistency, and fixity to the underlying structures), and ultrasonographic evaluation (number of LNs, shape, size (mm), location, borders, matting, peripheral halo, hilum, calcification, necrosis, reticulation, and echogenicity) of the LNs, and finally, histological assessment was done after surgical excision during the course of treatment.

Results: Predominantly male (65%) patients were having with malignant LN involvement with age group of 60-69 years, i.e., 35%. Ultrasonogram is superior to clinical examination as it detected additional 49 nodes. Malignant nodes tend to have longest axial diameter (17 mm with standard deviation of 8.7 mm). Over all 52 malignant nodes were round, whereas 35 nodes were oval in shape. Most of the nodes were detected in submandibular region. Around 61 (70.9%) nodes had sharp borders and 26 (29.9%) had smooth borders. Loss of echogenic hilus is a common feature of malignancy showing 70% sensitivity and 67% specificity. Most of malignant nodes were hypoechoic. Around 51 (58.6%) of nodes showed intranodal necrosis, whereas it was absent in 36 (41.4%) nodes. Matting and edema were present 25 (28.7%) nodes. Intranodal calcification was present in 37 nodes. Sensitivity of USG was 90%, whereas specificity was 100%.

Conclusion: Ultrasonographic examination of cervical LNs can yield important information regarding the diagnosis. Ultrasound examination should be done prior to FNAC and ideally an ultrasound-guided FNAC.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436247PMC
http://dx.doi.org/10.4103/jfmpc.jfmpc_440_18DOI Listing

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