Y J Liu1, Y T Lee, S W Hsieh, S H Kuo. 1. Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, R.O.C.
Abstract
OBJECTIVES: To evaluate the accuracy of presumption of the primary sites of neck lymph node metastases based on fine needle aspiration cytology. STUDY DESIGN: Retrospective review of 133 cytologically diagnosed carcinomas with known primary sites and sufficient cellularity during a three-year period. Presumption of primary sites was carried out on randomized samples six months later. RESULTS: Some cytomorphologic characteristics are useful for presumption of primary sites, such as monolayered papillary fronds with intranuclear cytoplasmic inclusions in thyroid papillary carcinoma; large, polygonal, keratinized cells with a low nuclear/cytoplasmic ratio and anucleated squames in perioral cancers; and numerous naked nuclei, destroyed nuclei and marked lymphocytic infiltrates in nasopharyngeal cancer. The accuracy rate of presumption of primary sites was 100% (6/6) in thyroid papillary carcinoma, 83% (24/29) in perioral cancer and 77% (26/34) in nasopharyngeal cancer but low in other malignancies. CONCLUSION: Utilizing cytomorphologic characteristics, a presumption of primary sites of neck lymph node metastases could be achieved for the thyroid, perioral areas and nasopharynx.
OBJECTIVES: To evaluate the accuracy of presumption of the primary sites of neck lymph node metastases based on fine needle aspiration cytology. STUDY DESIGN: Retrospective review of 133 cytologically diagnosed carcinomas with known primary sites and sufficient cellularity during a three-year period. Presumption of primary sites was carried out on randomized samples six months later. RESULTS: Some cytomorphologic characteristics are useful for presumption of primary sites, such as monolayered papillary fronds with intranuclear cytoplasmic inclusions in thyroid papillary carcinoma; large, polygonal, keratinized cells with a low nuclear/cytoplasmic ratio and anucleated squames in perioral cancers; and numerous naked nuclei, destroyed nuclei and marked lymphocytic infiltrates in nasopharyngeal cancer. The accuracy rate of presumption of primary sites was 100% (6/6) in thyroid papillary carcinoma, 83% (24/29) in perioral cancer and 77% (26/34) in nasopharyngeal cancer but low in other malignancies. CONCLUSION: Utilizing cytomorphologic characteristics, a presumption of primary sites of neck lymph node metastases could be achieved for the thyroid, perioral areas and nasopharynx.