Ultrasonic diagnosis of cervical metastatic lymph nodes of patients with head and neck cancer

To estimate the usefulness of diagnostic ultrasound for cervical lymph node metastasis in patients with head and neck cancer, 155 neck dissection specimens from 139 patients were examined. The results were as follows: 1. Ultrasound delineated 93% of the metastatic lymph nodes over 10 mm in short diameter. 2. The characteristic featurs of the secondary cervical lymph node metastasis were an increased short diameter (over 10 mm) and the appearance of internal echoes. 3. Accuracy of ultrasound was 85.0%. 4. False positive lymph nodes were found in the upper deep cervical nodes and submandibular nodes and were characterized by a high proportion of reactive lymphadenitis histopathologically. 5. False negative lymph nodes were found in all cervical lymph nodes and were characterized by a high proportion of micrometastasis histopathologically. The findings suggested that ultrasound is useful for diagnosis of cervical lymph node metastasis.