Tadataka Tsuji1, Koichi Satoh2, Hiroshi Nakano3, Yoshiya Nishide4, Yasuhiro Uemura5, Susumu Tanaka6, Mikihiko Kogo6. 1. Department of Oral and Maxillofacial Surgery, Saiseikai Matsusaka General Hospital, 15-6 Asahimachi 1-ku, Matsusaka City, Mie, 515-8557, Japan; First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita City, Osaka, 565-0871, Japan. Electronic address: g2787b@dent.osaka-u.ac.jp. 2. Department of Oral and Maxillofacial Surgery, Saiseikai Matsusaka General Hospital, 15-6 Asahimachi 1-ku, Matsusaka City, Mie, 515-8557, Japan. 3. Department of Pathology, Saiseikai Matsusaka General Hospital, 15-6 Asahimachi 1-ku, Matsusaka City, Mie, 515-8557, Japan. 4. Department of Radiology, Saiseikai Matsusaka General Hospital, 15-6 Asahimachi 1-ku, Matsusaka City, Mie, 515-8557, Japan. 5. Department of Hematology and Oncology, Saiseikai Matsusaka General Hospital, 15-6 Asahimachi 1-ku, Matsusaka City, Mie, 515-8557, Japan. 6. First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
Abstract
PURPOSE: Enlargement of cervical lymph nodes is required for early and accurate diagnosis of malignant lymphoma (ML). Lymph node biopsy is still indispensable for accurate diagnosis of lymph node enlargement in the lateral neck. MATERIAL AND METHODS: We retrospectively investigated the characteristics of lymph nodes on both ultrasonography (US) and computed tomography (CT), and blood biomarkers including serum thymidine kinase (TK) and soluble interleukin-2 receptor (sIL-2R) in 19 patients who underwent cervical lymph node biopsy. RESULTS: Pathological diagnosis was ML in 8 patients, reactive lymphadenopathy (RL) in 8, and purulent lymphadenitis (PL) in 3. TK levels were significantly higher in patients with ML than in patients with RL, demonstrating positive correlations with sIL-2R and lymph node size on CT image. The shape of lymph nodes on US in all of the 8 patients diagnosed with RL was flat, whereas the shape in 7 of 8 patients diagnosed with ML was round. Lymph node size ≥19.5 mm at an axial section on CT image was used as a cut-off value to differentiate ML from other pathologies, offering 90.9% sensitivity and 87.5% specificity. CONCLUSION: Sonographic and CT evaluation combined with high TK level might be useful in determining the need for early biopsy.
PURPOSE: Enlargement of cervical lymph nodes is required for early and accurate diagnosis of malignant lymphoma (ML). Lymph node biopsy is still indispensable for accurate diagnosis of lymph node enlargement in the lateral neck. MATERIAL AND METHODS: We retrospectively investigated the characteristics of lymph nodes on both ultrasonography (US) and computed tomography (CT), and blood biomarkers including serum thymidine kinase (TK) and soluble interleukin-2 receptor (sIL-2R) in 19 patients who underwent cervical lymph node biopsy. RESULTS: Pathological diagnosis was ML in 8 patients, reactive lymphadenopathy (RL) in 8, and purulent lymphadenitis (PL) in 3. TK levels were significantly higher in patients with ML than in patients with RL, demonstrating positive correlations with sIL-2R and lymph node size on CT image. The shape of lymph nodes on US in all of the 8 patients diagnosed with RL was flat, whereas the shape in 7 of 8 patients diagnosed with ML was round. Lymph node size ≥19.5 mm at an axial section on CT image was used as a cut-off value to differentiate ML from other pathologies, offering 90.9% sensitivity and 87.5% specificity. CONCLUSION: Sonographic and CT evaluation combined with high TK level might be useful in determining the need for early biopsy.
Authors: Mustafa Çolak; Fakih Cihat Eravcı; Süleyman Emre Karakurt; Mehmet Fatih Karakuş; Aykut İkincioğulları; Kürşat Murat Özcan Journal: Indian J Otolaryngol Head Neck Surg Date: 2019-06-05