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Head and Neck Squamous Cell Carcinoma: US-guided Fine-Needle Aspiration of Sentinel Lymph Nodes for Improved Staging—Initial Experience¹

¹ From the Departments of Otolaryngology/Head and Neck Surgery (D.R.C., E.J.C.N., M.W.M.v.d.B., R.H.B., G.B.S.), Radiology (J.A.C.), and Nuclear Medicine (R.P.), University Hospital Vrije Universiteit, De Boelelaan 1117, PO Box 7057, 1007 MB Amsterdam, the Netherlands. Received November 18, 1999; revision requested December 21; final revision received March 30, 2000; accepted April 4. Address correspondence to M.W.M.v.d.B. (e-mail: kno@azvu.nl).

Ultrasonography (US)-guided fine-needle aspiration with cytologic examination was combined with lymphoscintigraphy for the identification of sentinel lymph nodes (SLNs) in 12 patients with a squamous cell carcinoma of the oral cavity or oropharynx. Dynamic lymphoscintigraphy and a hand-held gamma probe were used to depict the SLNs to be aspirated. Cytologic examination of the aspirated SLNs revealed neck lymph node status in patients who underwent neck dissection (n = 6). In patients who underwent only transoral excision, one false-negative cytologic result was observed. This combined approach is expected to improve the detection of occult neck lymph node metastases.

Index terms: Head and neck neoplasms, diagnosis, 262.1262, 262.3751 • Head and neck neoplasms, radionuclide studies, 262.1262, 262.343 • Head and neck neoplasms, staging, 262.1262 • Lymphatic system, neoplasms, 997.1262, 997.12985 • Lymphatic system, radionuclide studies, 997.12961 • Ultrasound (US), guidance, 997.12985

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