The significance of enlarged cervical lymph nodes in diagnosing thyroid cancer

Hossam Eldin Mohamed; Salah Eldin Mohamed; Muhammad Ahmed Farooq Anwar; Zaid Al-Qurayshi; Andrew Sholl; Tina Thethi; Amna Khan; Rizwan Aslam; Emad Kandil

doi:10.4103/0973-1482.171360

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The significance of enlarged cervical lymph nodes in diagnosing thyroid cancer

Journal article

Open access

Peer reviewed

The significance of enlarged cervical lymph nodes in diagnosing thyroid cancer

Hossam Eldin Mohamed, Salah Eldin Mohamed, Muhammad Ahmed Farooq Anwar, Zaid Al-Qurayshi, Andrew Sholl, Tina Thethi, Amna Khan, Rizwan Aslam and Emad Kandil

Journal of cancer research and therapeutics, Vol.12(2), pp.1006-1009

04/01/2016

DOI: 10.4103/0973-1482.171360

PMID: 27461689

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Abstract

We aim to investigate the significance of enlarged cervical lymph nodes (ECLN) identified by initial surgeon-performed ultrasound (US) as a tool for determining the risk of malignancy in the patients presenting with suspicious thyroid nodules. Radiological and surgical reports were retrospectively reviewed for the patients with suspicious thyroid nodules who underwent thyroidectomy and preoperative comprehensive neck US. Ultrasonographic features of the identified cervical lymph nodes were correlated with the final pathology report. Patients with malignancy other than papillary thyroid cancer (PTC) were excluded. The study consisted of 440 patients. On final pathology, PTC was found in 142 patients (32.3%), the remaining 298 (67.7%) exhibited benign findings. ECLN (>1 cm) were found in 66 (46.5%) patient with PTC compared to only 53 (17.8%) patients with benign nodules (P < 0.001). Of the 119 patients with ECLN, 54.6% had benign appearing ECLN with no suspicious features, 26.1% had one suspicious feature, and 19.3% had more than one suspicious features. Benign appearing ECLN had a positive predictive value (PPV) of 41.54%, negative predictive value (NPV) of 59.02%, sensitivity of 51.92%, and specificity of 48.65% in predicting malignancy as opposed to the absence of ECLN. While as opposed to benign looking ECLN, ECLN with only one suspicious feature had a PPV of 70.97%, NPV of 50.00%, sensitivity of 33.33%, and specificity of 83.02%, and ECLN with two or more suspicious feature had a PPV of 73.91%, NPV of 48.96%, sensitivity of 25.76%, and specificity of 88.68%. ECLN are associated with an increased likelihood of thyroid malignancy in the patients undergoing evaluation of a suspicious nodule. The risk of malignancy in thyroid nodules increases with the presence of suspicious ultrasonographic features on cervical lymph nodes.

Adult

Biopsy, Fine-Needle

Carcinoma - diagnosis

Carcinoma, Papillary

Diagnosis, Differential

Female

Humans

Lymph Node Excision

Lymph Nodes - pathology

Male

Middle Aged

Neck - pathology

Retrospective Studies

Sensitivity and Specificity

Thyroid Cancer, Papillary

Thyroid Neoplasms - diagnosis

Thyroid Nodule - diagnosis

Ultrasonography

Details

Title: Subtitle: The significance of enlarged cervical lymph nodes in diagnosing thyroid cancer
Creators: Hossam Eldin Mohamed - Tulane University
Salah Eldin Mohamed - Tulane University
Muhammad Ahmed Farooq Anwar - University of New Orleans
Zaid Al-Qurayshi - University of New Orleans
Andrew Sholl - Tulane University
Tina Thethi - Tulane University
Amna Khan - Tulane University
Rizwan Aslam - Tulane University
Emad Kandil - Tulane University
Resource Type: Journal article
Publication Details: Journal of cancer research and therapeutics, Vol.12(2), pp.1006-1009
DOI: 10.4103/0973-1482.171360
PMID: 27461689
ISSN: 0973-1482
eISSN: 1998-4138
Language: English
Date published: 04/01/2016
Academic Unit: Otolaryngology
Record Identifier: 9984702821002771

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