2016_Head & Neck COURSE BOOK

IDENTIFICATION OF THE PRIMARY TUMOR

FNAC

EFFICIENT, MINIMALLY INVASIVE, AND COST-EFFECTIVE DIAGNOSTIC METHOD WITH NEGLIGIBLE RISK OF SEEDING TUMOR CELLS ALONG THE NEEDLE TRACK

FOR METASTATIC LESIONS: SENSITIVITY: 83-97% SPECIFICITY: 91-100%

SCC ACCOUNTS FOR 53-77% THE REMAINING ARE ADENOCARCINOMA AND UNDIFFERENTIATED CARCINOMA

BUT....IN CYSTIC METASTASES , A FALSE-NEGATIVE RATE OF 42% WITH FNAC IS REPORTED WITH SENSITIVITY RANGING FROM 33% TO 50%, BECAUSE IT CAN BE DIFFICULT TO DISTINGUISH CYSTIC METASTASES FROM BENIGN BRANCHIAL CYSTS, ABSCESS, OR TUBERCULOSIS

Open cervical lymphnode biopsy is indicated only when repeated FNAC followed by a core-needle- biopsy are nondiagnostic or in patients with masses clinically and histologically suspicious for lymphoma

Gourin et al., Laryngoscope 2000 Layfield, Diagn Cytopathol 2007 Cianchetti et al., Laryngoscope 2009

mercoledì 29 giugno 16