Nonpalpable lymph nodes of the neck: assessment with US and US-guided fine-needle aspiration biopsy

J Clin Ultrasound. 1997 Jul-Aug;25(6):283-92. doi: 10.1002/(sici)1097-0096(199707)25:6<283::aid-jcu1>;2-8.


Ultrasound (US) and US-guided fine-needle aspiration biopsy (FNA) were performed in 91 nonpalpable neck nodes of 70 patients, 98% of which had known malignancy. Various sonographic findings were evaluated for predicting malignancy. The accuracy of US-guided FNA for detecting malignancy was 88%, with 96% sensitivity and 94% specificity. The ratio of minimal to maximal axial diameters of a node was most valid for predicting malignancy with US. A ratio of more than 0.55 yielded the highest accuracy (80%) (92% sensitivity, 63% specificity). Addition of any other factors to this criterion did not improve its accuracy. US and US-guided FNA are accurate for the assessment of nonpalpable neck nodes. Lymph nodes with a round configuration should be biopsied in patients with known malignancy.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle / methods*
  • Female
  • Humans
  • Lymph Nodes / diagnostic imaging*
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / diagnostic imaging*
  • Male
  • Middle Aged
  • Neck
  • Neoplasms / diagnosis
  • Sensitivity and Specificity
  • Ultrasonography / methods