OBJECTIVE: The purpose of this study is to determine the utility of cervical lymph node fine needle aspiration (FNA) in patients with sonographically normal lymph nodes and without history of malignancy. METHODS: A total of 24 adult patients without prior history of malignancy who had ultrasound-guided FNA of a single enlarged cervical lymph node were identified. Images of lymph nodes in these patients were retrospectively evaluated for characteristics indicative of malignancy-shape, sharpness of borders, absence of an echogenic hilum, calcifications, necroses/cysts, and peripheral vascularity. These results were correlated with histopathologic findings. Findings were also correlated with specific clinical findings that may have lead to the referral for FNA RESULTS: The only sonographic characteristic with a significant association with lymph node malignancy was the absence of an echogenic hilus. No significant correlation was found between the clinical findings evaluated and the cervical lymph node benignity or malignancy. CONCLUSION: The presence of a sonographic echogenic hilus in the lymph nodes of patients with no history of malignancy favors benignity. This feature and other sonographic and clinical findings must be considered when deciding whether FNA is indicated.
OBJECTIVE: The purpose of this study is to determine the utility of cervical lymph node fine needle aspiration (FNA) in patients with sonographically normal lymph nodes and without history of malignancy. METHODS: A total of 24 adult patients without prior history of malignancy who had ultrasound-guided FNA of a single enlarged cervical lymph node were identified. Images of lymph nodes in these patients were retrospectively evaluated for characteristics indicative of malignancy-shape, sharpness of borders, absence of an echogenic hilum, calcifications, necroses/cysts, and peripheral vascularity. These results were correlated with histopathologic findings. Findings were also correlated with specific clinical findings that may have lead to the referral for FNA RESULTS: The only sonographic characteristic with a significant association with lymph node malignancy was the absence of an echogenic hilus. No significant correlation was found between the clinical findings evaluated and the cervical lymph node benignity or malignancy. CONCLUSION: The presence of a sonographic echogenic hilus in the lymph nodes of patients with no history of malignancy favors benignity. This feature and other sonographic and clinical findings must be considered when deciding whether FNA is indicated.