The role of ultrasound and ultrasound-guided fine needle aspiration biopsy of lymph nodes in patients with skin tumours

doi:10.2478/raon-2013-0084

. 2014 Jan 22;48(1):29-34.

doi: 10.2478/raon-2013-0084. eCollection 2014 Mar.

The role of ultrasound and ultrasound-guided fine needle aspiration biopsy of lymph nodes in patients with skin tumours

Francesco Maria Solivetti¹, Fulvia Elia¹, Maria Giulia Santaguida², Antonino Guerrisi¹, Paolo Visca³, Maria Cecilia Cercato⁴, Aldo Di Carlo⁵

Affiliations

¹ Radiologia e Diagnostica per Immagini, I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano, Rome, Italy.
² Radiologia e Diagnostica per Immagini, I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano, Rome, Italy ; Sapienza Università di Roma, Dpt. Scienze Biotecnologie Medico-Chirurgiche, Rome, Italy.
³ Struttura di Anatomia ed Istologia Patologica e Citodiagnostica, I.R.C.C.S. Istituto Regina Elena, Rome, Italy.
⁴ Epidemiologia, Istituto Regina Elena, Rome, Italy.
⁵ Direzione Scientifica, I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano, Rome, Italy.

PMID: 24587776
PMCID: PMC3908844
DOI: 10.2478/raon-2013-0084

The role of ultrasound and ultrasound-guided fine needle aspiration biopsy of lymph nodes in patients with skin tumours

Francesco Maria Solivetti et al. Radiol Oncol. 2014.

. 2014 Jan 22;48(1):29-34.

doi: 10.2478/raon-2013-0084. eCollection 2014 Mar.

Authors

Francesco Maria Solivetti¹, Fulvia Elia¹, Maria Giulia Santaguida², Antonino Guerrisi¹, Paolo Visca³, Maria Cecilia Cercato⁴, Aldo Di Carlo⁵

Affiliations

¹ Radiologia e Diagnostica per Immagini, I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano, Rome, Italy.
² Radiologia e Diagnostica per Immagini, I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano, Rome, Italy ; Sapienza Università di Roma, Dpt. Scienze Biotecnologie Medico-Chirurgiche, Rome, Italy.
³ Struttura di Anatomia ed Istologia Patologica e Citodiagnostica, I.R.C.C.S. Istituto Regina Elena, Rome, Italy.
⁴ Epidemiologia, Istituto Regina Elena, Rome, Italy.
⁵ Direzione Scientifica, I.R.C.C.S Istituto Dermosifilopatico di Santa Maria e San Gallicano, Rome, Italy.

PMID: 24587776
PMCID: PMC3908844
DOI: 10.2478/raon-2013-0084

Abstract

Background: The primary aim of this study was to evaluate the diagnostic accuracy of ultrasound (US) in the study of superficial lymph nodes during the follow-up of patients surgically treated for skin tumours. The secondary objective was to compare positive cytological results with histological reports.

Patients and methods: From 2004 to 2011, 480 patients (male/female: 285/195; median age 57 years; prevalent skin tumour: melanoma) underwent US-guided fine-needle aspiration biopsy (FNAB) of suspicious recurrent lymph nodes. An expert radiologist first performed US testing of the lymph nodes, expressing either a negative or positive outcome of the test. Subsequently, US-guided FNAB was performed. FNAB positive patients were subjected to lymphadenectomy; the patients who tested negative underwent the follow-up.

Results: The size of lymph nodes was ≤ 2 cm in 90% of cases. Out of the 336 (70%) US "positive" patients, 231 (68.8%) were FNAB positives. Out of the 144 (30%) US "negatives", 132 (91.7%) were FNAB negatives. The sensitivity and specificity of the US were 95% and 55.7%, respectively; the negative predictive value was 91.7% and the positive predictive value was 68.8%. Definitive histological results confirmed FNAB positivity in 97.5% of lymphadenectomies.

Conclusions: US is a sensitive method in the evaluation of superficial lymph nodes during the follow-up of patients with skin tumours. High positive predictive value of cytology was confirmed.

Keywords: fine needle aspiration biopsy, follow-up; skin tumours; ultrasound.

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Figures

**FIGURE 1.**
Flow-chart describing lymph-nodes analysed by ultrasound and FNAB cytology. LFN = lymph-nodes investigated; US− = ultrasound negative for lymph-node metastasis; US+ = ultrasound positive for lymph-node metastasis; FNAB = fine-needle aspiration biopsy; FNAB− = FNAB negative for lymph-node metastasis; FNAB+ = FNAB positive for lymph-node metastasis

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[1] Catalano O, Siani A. Cutaneous melanoma: role of ultrasound in the assessment of locoregional spread. Curr Probl Diagn Radiol. 2010;39:30–6. - PubMed

[2] Catalano O, Siani A. Cutaneous melanoma: role of ultrasound in the assessment of locoregional spread. Curr Probl Diagn Radiol. 2010;39:30–6. - PubMed

[3] Thompson JF, Haydu LE, Sanki A, Uren RF. Ultrasound assessment of lymph nodes in the management of early-stage melanoma. J Surg Oncol. 2011;104:354–60. - PubMed

[4] Thompson JF, Haydu LE, Sanki A, Uren RF. Ultrasound assessment of lymph nodes in the management of early-stage melanoma. J Surg Oncol. 2011;104:354–60. - PubMed

[5] Francken AB, Bastiaannet E, Hoekstra HJ. Follow-up in patients with localised primary cutaneous melanoma. Lancet Oncol. 2005;6:608–21. - PubMed

[6] Francken AB, Bastiaannet E, Hoekstra HJ. Follow-up in patients with localised primary cutaneous melanoma. Lancet Oncol. 2005;6:608–21. - PubMed

[7] Blum A, Schlagenhauff B, Stroebel W, Breuninger H, Rassner G, Garbe C. Ultrasound examination of regional lymph nodes significantly improves early detection of locoregional metastases during the follow-up of patients with cutaneous melanoma: results of a prospective study of 1288 patients. Cancer. 2000;88:2534–9. - PubMed

[8] Blum A, Schlagenhauff B, Stroebel W, Breuninger H, Rassner G, Garbe C. Ultrasound examination of regional lymph nodes significantly improves early detection of locoregional metastases during the follow-up of patients with cutaneous melanoma: results of a prospective study of 1288 patients. Cancer. 2000;88:2534–9. - PubMed

[9] Krüger U, Kretschmer L, Thoms KM, Padeken M, Peter Bertsch H, Schön MP, et al. Lymph node ultrasound during melanoma follow-up significantly improves metastasis detection compared with clinical examination alone: a study on 433 patients. Melanoma Res. 2011;21:457–63. - PubMed

[10] Krüger U, Kretschmer L, Thoms KM, Padeken M, Peter Bertsch H, Schön MP, et al. Lymph node ultrasound during melanoma follow-up significantly improves metastasis detection compared with clinical examination alone: a study on 433 patients. Melanoma Res. 2011;21:457–63. - PubMed

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The role of ultrasound and ultrasound-guided fine needle aspiration biopsy of lymph nodes in patients with skin tumours

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The role of ultrasound and ultrasound-guided fine needle aspiration biopsy of lymph nodes in patients with skin tumours

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