Presumption of primary sites of neck lymph node metastases on fine needle aspiration cytology.

Abstract

To evaluate the accuracy of presumption of the primary sites of neck lymph node metastases based on fine needle aspiration cytology. 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. 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. Utilizing cytomorphologic characteristics, a presumption of primary sites of neck lymph node metastases could be achieved for the thyroid, perioral areas and nasopharynx.