Localization of cervical node metastasis of papillary thyroid carcinoma

Precise localization of cervical node metastasis of papillary thyroid carci noma is rarely described. The aim of this retrospective study was to map th eir cervical involvement. Between 1974 and 1996 a series of 119 patients ha d total thyroidectomy with bilateral cervical lymph node dissection. Patien ts who had secondary node dissection for a cervical recurrence were exclude d. Eight node sites were distinguished (ipsilateral and contralateral): par atracheal, mid-jugular, supraclavicular, subdigastric. All pathologic speci mens were reviewed by a single pathologist. Twenty-five patients had lymph node involvement clinically before surgery. Seventy-two (60.5%) had cervica l metastasis (N+: node positive patients), with bilateral involvement in 28 cases. In cases of bilateral thyroid tumor localization, ipsilateral disse ction designated the side with the largest nodule. The main ipsilateral inv olved sites were paratracheal (60 patients), mid-jugular (44 patients), and supraclavicular (26 patients). Contralateral paratracheal nodes were invol ved in 25 patients and mid-jugular nodes in 12. Among the N+ patients, node involvement was absent in 11 cases at paratracheal, 28 jugular, and 46 sub clavicular sites. Cervical node metastases concerned 60.5% of the patients, with bilateral involvement in 40.8% of the N+ patients. Ipsilateral paratr acheal and jugular sites were most frequently involved. The lateral compart ment was sometimes involved independent of the central compartment.