Aspiration Biopsy of Metastatic Carcinoma in Lymph Nodes of the Neck: A Review of 1 101 Consecutive Cases

From 1955 through 1966, metastatic carcinoma of lymph nodes of the neck was diagnosed in 1 101 patients by cytologic study of aspirate obtained by fine-needle biopsy. The primary tumours were located above the clavicle in 522 patients (47.4 %) and below this level in 529 (48.0 %). The primary tumour remained unknown in 50 patients (4.5 %). The cytologic diagnosis of metastasis was the first confirmation of malignancy in 382 patients (34.7 %). In the first month thereafter, no primary tumour was found in 133 of these patients (12.1 % of the series). The diagnosis was unknown at death in 79 patients (7.2 %). In a five-year follow-up of 656 consecutively examined patients the survival rate varied considerably, depending on the site of the primary tumour. The calculated five-year survival rate for the total series was 25.2%. Comparisons between the cytologic reports and subsequent histologic studies of the same lymph nodes were made in 257 cases. In 17 cases (6.6 %) a false negative cytologic report was given.