PRESUMPTION OF PRIMARY SITES OF NECK LYMPH-NODE METASTASES ON FINE-NEEDLE ASPIRATION CYTOLOGY

OBJECTIVES: To evaluate the accuracy of presumption of the primary sit es of neck lymph node metastases based on fine needle aspiration cytol ogy. STUDY DESIGN: Retrospective review of 133 cytologically diagnosed carcinomas with known primary sites and sufficient cellularity during a three-year period. Presumption of primary sites was carried out on randomized samples six months later. RESULTS: Some cytomorphologic cha racteristics are useful for presumption of primary sites, such as mono -layered papillary fronds with intranuclear cytoplasmic inclusions in thyroid papillary carcinoma; large, polygonal, keratinized cells with a low nuclear/cytoplasmic ratio and anucleated squames in perioral can cers; and numerous naked nuclei, destroyed nuclei and marked lymphocyt ic infiltrates in nasopharyngeal cancer. The accuracy rate of presumpt ion of primary sites was 100% (6/6) in thyroid papillary carcinoma, 83 % (24/29) in perioral cancer and 77% (26/34) in nasopharyngeal cancer but low in other malignancies. CONCLUSION: Utilizing cytomorphologic c haracteristics, a presumption of primary sites of neck lymph node meta stases could be achieved for the thyroid, perioral areas and nasophary nx.