FNA – Oral Cancer News

Large Thyroid Nodules Linked to High Malignancy Risk

Elsevier Global Medical News Author - MG Sullivan PARIS (EGMN) - Patients with a non-decisive fine-needle aspiration for large non-diagnostic thyroid nodules or lesions of undetermined significance should be considered for surgery because more than half of these large nodules can be malignant. In a review of 156 patients with non-decisive fine-needle aspirations (FNAs), nodule size was a major determinant in surgical referral, Dr. Susana Mascarell said at the International Thyroid Congress. "Nodules of this size were associated with a malignancy rate of up to 60%," said Dr. Mascarell of the John H. Stroger Jr. Hospital of Cook County, Chicago. FNA is considered the main diagnostic tool in deciding which patient to refer to surgery. "However," Dr. Mascarell said, "the FNA results may not be helpful when the cytology specimen is non-diagnostic or qualifies as a follicular lesion of undetermined significance - both classifications that are part of the new six-level FNA classification system suggested by the National Cancer Institute." When an FNA comes back as non-decisive on such specimens, the clinician must choose between surgery and clinical follow-up as the next step. Unfortunately, said Dr. Mascarell, there are no hard-and-fast rules about which management path to choose. Molecular markers are becoming more important in the decision, but can't be relied upon in every patient, she said. "When these markers are present in high concentrations, they are up to 99% accurate in identifying malignant nodules and so are a very helpful tool. But only 40% of nodules are positive for [...]

Charlotte Parker2010-10-26T13:38:00-07:00October, 2010|Oral Cancer News|

Office-based ultrasound-guided FNA found to be superior in diagnosing head and neck lesions

Source: American Academy of Otolaryngology Author: Jessica Mikulski Office-based, surgeon-performed, ultrasound-guided, fine needle aspiration (FNA) of head and neck lesions yields a statistically significant higher diagnostic rate compared to the standard palpation technique, indicates new research in the March 2010 issue of Otolaryngology - Head and Neck Surgery. FNA is a diagnostic procedure used to investigate superficial lumps or masses. In this technique, a thin, hollow needle is inserted into a mass to extract cells for examination. FNA biopsies are a safe minor surgical procedure. Often, a major surgical (excisional or open) biopsy can be avoided by performing a needle aspiration biopsy instead. FNA biopsies in the head and neck have also proven to be an invaluable tool in establishing the diagnosis of lesions and masses from a broad range of sites, including the thyroid, salivary glands, and lymph nodes. The efficacy of ultrasound-guided FNA has been well documented in many areas of the body, leading to its acceptance as the standard of care among radiologists and many cytopathologists. However, while the utility of ultrasound in the head and neck is widely appreciated and employed by the radiology community, clinicians in the United States have not embraced office-based ultrasound. The study authors sought to provide additional evidence and support for this procedure in order to ensure appropriate use by the clinical community. In this randomized, controlled trial of 81 adults, researchers divided participants into two groups, using either ultrasound-guided or traditional palpation-guided FNA to evaluate an identified head and neck mass. [...]

Charlotte Parker2010-03-11T18:54:05-07:00March, 2010|Oral Cancer News|

Ultrasonography-guided fine-needle aspiration for the assessment of cervical metastases

Source: Arch Otolaryngol Head Neck Surg. 2000;126:1091-1096 Authors: Marco Knappe, MD et al. Objective: To assess the value of ultrasonography (US) combined with fine-needle aspiration (FNA) cytology for the investigation of lymph node metastases in patients with head and neck cancer. Design: Comparison of clinical examination (palpation) and preoperative US-FNA examination results of cervical nodes in a sample of patients with head and neck cancer. The histological features of the neck dissection specimens are used to validate these 2 variables. Setting: A head and neck oncology service in a tertiary referral hospital. Patients: A consecutive sample of 56 patients with head and neck squamous cell carcinoma, first seen between April 1, 1996, and July 30, 1998, who had neck dissections performed after the US-FNA examination. Intervention: Cervical US-FNA preoperatively, followed by elective or therapeutic radical modified or selective neck dissection. Main Outcome Measures: The histological examination results of subsequent neck dissection specimens are used to determine the sensitivity, specificity, and accuracy of US-FNA for individual nodes. Second, the results of node staging by clinical examination and US-FNA examination are compared. Results: The sensitivity was 89.2%; specificity, 98.1%; and accuracy, 94.5%. Correct node stages were obtained in 52 (93%) of the patients using US-FNA compared with 34 (61%) using palpation. Conclusions: Ultrasonography combined with FNA is a highly accurate technique for the investigation of cervical lymph node metastases. A more accurate diagnosis may result in more appropriate treatment, particularly in a setting with limited resources. Retropharyngeal nodes, micrometastases, and lymph nodes [...]

Oral Cancer Foundation News Team - A2009-09-22T06:11:47-07:00September, 2009|Oral Cancer News|