High frequency of incidental diagnosis of extrathyroidal neoplastic diseases at the fine-needle aspiration biopsy of laterocervical lymph nodes in patients with thyroid nodules

This study was undertaken to evaluate the frequency of the incidental diagn osis of extrathyroidal lymph node diseases at ultrasound-guided fine-needle aspiration biopsy/cytology (FNAB/C) being done to check the presence of me tastatic thyroid cancer in 30 subjects with thyroid nodule (TN) and enlarge d cervical lymph nodes (CLN). The patients in whom cytology suggested the p resence of malignancy in the TN or in the CLN underwent surgical removal fo r histologic diagnosis. The spectrum of diseases revealed by this survey in cluded: (1) 10 benign diseases including 1 case of Piringer-Kuchinka lympha denitis with benign TN; (2) 10 metastatic thyroid cancers (2 anaplastic and 8 papillary cancers); (3) 3 benign TN associated with metastatic invasion of cervical lymph nodes from lung (2 cases) and breast (1 case) cancer; (4) 1 Hodgkin's lymphoma of the cervical lymph nodes with hyperplastic TN; (5) 3 nodal lymphomas with benign thyroid nodule and 2 cases of thyroid lympho ma with nodal invasion; and (6) 1 nodal sarcoidosis with benign TN. The res ults of this study demonstrate that important neoplastic and hematologic di seases affecting the cervical lymph nodes may frequently be incidentally de tected using ultrasonography (US) and FNAB/C in the diagnostic procedure fo r thyroid nodule.