The role of high resolution ultrasound with guided cytology of groin lymphnodes in the management of squamous cell carcinoma of the vulva: a pilot study

The accuracy of high resolution ultrasound with guided fine needle aspirati on cytology in detecting inguinal lymph node involvement was assessed in 24 women undergoing radical vulvectomy and groin node dissection for squamous cell vulval cancer. Of the 43 groins dissected, ultrasound correctly diagn osed the lymph node status in 36, with five false positive and two false ne gative results. Cytology in 40 groins showed no false positive and five fal se negative results. The sensitivity and specificity for the combined techn iques were 83% and 82% respectively. Assessed together, the combined techni que failed to detect metastatic disease in two groins; in both cases the ex tent of nodal metastatic involvement was a solitary focus < 3 mm in diamete r. The ultrasound and fine needle aspiration procedure is safe and well tol erated and can be repeated as needed for surveillance. The authors suggest that this procedure should be evaluated further to determine whether a poli cy of individual selection for lymphadenectomy can be implemented based on this technique.