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Ultrasound and Mapping of Neck Lymph Nodes

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Thyroid Ultrasound and Ultrasound-Guided FNA

Abstract

The strategic value of ultrasound imaging in both treating and following patients with thyroid cancer has become increasingly appreciated over the past decade. Ultrasound has been incorporated into the American Thyroid Association’s Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer. Neck sonography has become pivotal in planning the preoperative surgical approach in patients undergoing initial thyroid cancer surgery as well as in the postoperative surveillance of patients with thyroid cancer. The key to determining the extent of the appropriate initial surgery as well as the recognition of recurrent cancer is ultrasound’s ability to detect early malignancy in the surrounding neck lymph nodes.

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References

  1. Carty SE, Cooper DS, et al. Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid. 2009;19(11):1153–8.

    Article  PubMed  Google Scholar 

  2. Ahuja A, Ying M, Phil M, King A, Yuen HY. Lymph node hilus—gray scale and power Doppler sonography of cervical nodes. J Ultrasound Med. 2001;20:987–92.

    PubMed  CAS  Google Scholar 

  3. Ahuja A, Ying M, Yuen H, Metreweli C. Power Doppler sonography of metastatic nodes from papillary carcinoma of the thyroid. Clin Radiol. 2001;56:284–8.

    Article  PubMed  CAS  Google Scholar 

  4. Ahuja A, Ying M. An overview of neck node sonography. Invest Radiol. 2002;37:333–42.

    Article  PubMed  Google Scholar 

  5. Ballantone R, Lombardi C, Raffaelli M, Traini E, Crea C, Rossi E, et al. Management of cystic thyroid nodules: the role of ultrasound-guided fine-needle aspiration biopsy. Thyroid. 2004;14:43–7.

    Article  Google Scholar 

  6. Frasoldati A, Toschi E, Zini M, Flora M, Caroggio A, Dotti C, et al. Role of thyroglobulin measurement in fine-needle aspiration biopsies of cervical lymph nodes in patients with differentiated thyroid cancer. Thyroid. 1999;9:105–11.

    Article  PubMed  CAS  Google Scholar 

  7. Pacini F, Fugazzola L, Lippi F, Ceccarelli C, Centoni R, Miccoli P, Elisei R, Pinchera A. Detection of thyroglobulin the needle aspirates of nonthyroidal neck masses: a clue to the diagnosis of metastatic differentiated thyroid cancer. J Clin Endocrinol Metab. 1992;74:1401–4.

    Article  PubMed  CAS  Google Scholar 

  8. Baskin HJ. Detection of recurrent papillary thyroid carcinoma by thyroglobulin assessment in the needle washout after fine-needle aspiration of suspicious lymph nodes. Thyroid. 2004;14:959–63.

    Article  PubMed  Google Scholar 

  9. Lee M, Ross D, Mueller P, Daniels G, Dawson S, Simeone J. Fine-needle biopsy of cervical lymph nodes in patients with thyroid cancer: a prospective comparison of cytopathologic and tissue marker analysis. Radiology. 1993;187:851–4.

    PubMed  CAS  Google Scholar 

  10. Cignarelli M, Ambrosi A, Marino A, Lamacchia O, Campo M, Picca G. Diagnostic utility of thyroglobulin detection in fine-needle aspiration of cervical cystic metastatic lymph nodes from papillary thyroid cancer with negative cytology. Thyroid. 2003;13:1163–7.

    Article  PubMed  CAS  Google Scholar 

  11. Gemsenjager E, Perren A, et al. Lymph node surgery in papillary thyroid carcinoma. J Am Coll Surg. 2003;197(2):182–90.

    Article  PubMed  Google Scholar 

  12. Bardet S, Malville E, et al. Macroscopic lymph-node involvement and neck dissection predict lymph-node recurrence in papillary thyroid carcinoma. Eur J Endocrinol. 2008;158(4):551–60.

    Article  PubMed  CAS  Google Scholar 

  13. Cranshaw IM, Carnaille B. Micrometastases in thyroid cancer. An important finding? Surg Oncol. 2008;17(3):253–8.

    Article  PubMed  Google Scholar 

  14. Noguchi M, Hashimoto T, et al. Indications for bilateral neck dissection in well-differentiated carcinoma of the thyroid. Jpn J Surg. 1987;17(6):439–44.

    Article  PubMed  CAS  Google Scholar 

  15. Noguchi S, Murakami N. The value of lymph-node dissection in patients with differentiated thyroid cancer. Surg Clin North Am. 1987;67(2):251–61.

    PubMed  CAS  Google Scholar 

  16. Mirallie E, Visset J, et al. Localization of cervical node metastasis of papillary thyroid carcinoma. World J Surg. 1999;23(9):970–3; discussion 973–4.

    Google Scholar 

  17. Qubain SW, Nakano S, et al. Distribution of lymph node micrometastasis in pN0 well-differentiated thyroid carcinoma. Surgery. 2002;131(3):249–56.

    Article  PubMed  Google Scholar 

  18. Wang TS, Dubner S, et al. Incidence of metastatic well-differentiated thyroid cancer in cervical lymph nodes. Arch Otolaryngol Head Neck Surg. 2004;130(1):110–3.

    Article  PubMed  Google Scholar 

  19. Triponez F, Poder L, et al. Hook needle-guided excision of recurrent differentiated thyroid cancer in previously operated neck compartments: a safe technique for small, nonpalpable recurrent disease. J Clin Endocrinol Metab. 2006;91(12):4943–7.

    Article  PubMed  CAS  Google Scholar 

  20. Ito Y, Higashiyama T, et al. Risk factors for recurrence to the lymph node in papillary thyroid carcinoma patients without preoperatively detectable lateral node metastasis: validity of prophylactic modified radical neck dissection. World J Surg. 2007;31(11):2085–91.

    Article  PubMed  Google Scholar 

  21. Lee SK, Choi JH, et al. Sentinel lymph node biopsy in papillary thyroid cancer: comparison study of blue dye method and combined radioisotope and blue dye method in papillary thyroid cancer. Eur J Surg Oncol. 2009;35(9):974–9.

    Article  PubMed  CAS  Google Scholar 

  22. Lim YC, Choi EC, et al. Central lymph node metastases in unilateral papillary thyroid microcarcinoma. Br J Surg. 2009;96(3):253–7.

    Article  PubMed  CAS  Google Scholar 

  23. Ross DS, Litofsky D, et al. Recurrence after treatment of micropapillary thyroid cancer. Thyroid. 2009;19(10):1043–8.

    Article  PubMed  Google Scholar 

  24. Baudin E, Travagli JP, et al. Microcarcinoma of the thyroid gland: the Gustave-Roussy Institute experience. Cancer. 1998;83(3):553–9.

    Article  PubMed  CAS  Google Scholar 

  25. Yamashita H, Noguchi S, et al. Extracapsular invasion of lymph node metastasis. A good indicator of disease recurrence and poor prognosis in patients with thyroid microcarcinoma. Cancer. 1999;86(5):842–9.

    Article  PubMed  CAS  Google Scholar 

  26. Chow SM, Law SC, et al. Papillary microcarcinoma of the thyroid—prognostic significance of lymph node metastasis and multifocality. Cancer. 2003;98(1):31–40.

    Article  PubMed  Google Scholar 

  27. Ito Y, Uruno T, et al. An observation trial without surgical treatment in patients with papillary microcarcinoma of the thyroid. Thyroid. 2003;13(4):381–7.

    Article  PubMed  Google Scholar 

  28. Wada N, Duh QY, et al. Lymph node metastasis from 259 papillary thyroid microcarcinomas: frequency, pattern of occurrence and recurrence, and optimal strategy for neck dissection. Ann Surg. 2003;237(3):399–407.

    PubMed  Google Scholar 

  29. Roti E, Rossi R, et al. Clinical and histological characteristics of papillary thyroid microcarcinoma: results of a retrospective study in 243 patients. J Clin Endocrinol Metab. 2006;91(6):2171–8.

    Article  PubMed  CAS  Google Scholar 

  30. Hay ID. Management of patients with low-risk papillary thyroid carcinoma. Endocr Pract. 2007;13(5):521–33.

    PubMed  Google Scholar 

  31. Mazzaferri EL. Management of low-risk differentiated thyroid cancer. Endocr Pract. 2007;13(5):498–512.

    PubMed  Google Scholar 

  32. Hay ID, Hutchinson ME, et al. Papillary thyroid microcarcinoma: a study of 900 cases observed in a 60-year period. Surgery. 2008;144(6):980–7; discussion 987–8.

    Google Scholar 

  33. Noguchi S, Yamashita H, et al. Papillary microcarcinoma. World J Surg. 2008;32(5):747–53.

    Article  PubMed  Google Scholar 

  34. Giordano D, Gradoni P, et al. Treatment and prognostic factors of papillary. Clin Otolaryngol. 2010;35(2):118–24.

    Article  PubMed  CAS  Google Scholar 

  35. So YK, Son YI, et al. Subclinical lymph node metastasis in papillary microcarcinoma: a study of 551 resections. Surgery. 2010;148(3):526–31.

    Article  PubMed  Google Scholar 

  36. Zetoune T, Keutgen X, et al. Prophylactic central neck dissection and local recurrence in papillary thyroid cancer: a meta-analysis. Ann Surg Oncol. 2010;17(12):3287–93.

    Article  PubMed  Google Scholar 

  37. Moreno MA, Agarwal G, et al. Preoperative lateral neck ultrasonography as a long-term outcome predictor in papillary thyroid cancer. Arch Otolaryngol Head Neck Surg. 2011;137(2):157–62.

    Article  PubMed  Google Scholar 

  38. Ito Y, Jikuzono T, et al. Clinical significance of lymph node metastasis of thyroid papillary carcinoma located in one lobe. World J Surg. 2006;30(10):1821–8.

    Article  PubMed  Google Scholar 

  39. Lesnik, Randolph, et al. Papillary thyroid carcinoma nodal surgery directed by a preoperative radiographic map utilizing CT scan and ultrasound in all primary and reoperative patients. WJS (submitted).

    Google Scholar 

  40. Pineda J, Lee T, Ain K, et al. Iodine-131 therapy for thyroid cancer patients with elevated thyroglobulin and negative diagnostic scan. J Clin Endocrinol Metab. 1995;80:1488–92.

    Article  PubMed  CAS  Google Scholar 

  41. Schumberger M, Arcangioli O, Piekarski J, et al. Detection and treatment of lung metastases of differentiated thyroid carcinoma in patients with normal chest x-ray. J Nucl Med. 1988;29:1790–4.

    Google Scholar 

  42. Torre E, Carballo M, Erdozain R, Lienas L, Iriarte M, Layana J. Prognostic value of thyroglobulin and I-131 whole-body scan after initial treatment of low-risk differentiated thyroid cancer. Thyroid. 2004;14:301–6.

    Article  Google Scholar 

  43. Park H, Perkins O, Edmondson J. Influence of diagnostic radioiodines on the uptake of ablative dose of iodine-131. Thyroid. 1994;4:49–54.

    Article  PubMed  CAS  Google Scholar 

  44. Frasoldati A, Presenti M, Gallo M, Coroggio A, Salvo D, Valcavi R. Diagnosis of neck recurrences in patients with differentiated thyroid carcinoma. Cancer. 2003;97:90–6.

    Article  PubMed  Google Scholar 

  45. Rondeau G, Fish S, et al. Ultrasonographically detected small thyroid bed nodules identified after total thyroidectomy for differentiated thyroid cancer seldom show clinically significant structural progression. Thyroid. 2011;21(8):845–53.

    Article  PubMed  Google Scholar 

  46. Al-Saif O, Farrar WB, et al. Long-term efficacy of lymph node reoperation for persistent papillary thyroid cancer. J Clin Endocrinol Metab. 2010;95(5):2187–94.

    Article  PubMed  CAS  Google Scholar 

  47. Schuff KG, Weber SM, et al. Efficacy of nodal dissection for treatment of persistent/recurrent papillary thyroid cancer. Laryngoscope. 2008;118(5):768–75.

    Article  PubMed  Google Scholar 

  48. Clayman GL, Shellenberger TD, et al. Approach and safety of comprehensive central compartment dissection in patients with recurrent papillary thyroid carcinoma. Head Neck. 2009;31(9):1152–63.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. General and Thyroid Surgical Divisions Mass Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA

    Gregory Randolph MD, FACS

  2. Beth Israel Deaconess Medical Center, Natick, MA, USA

    Barry Sacks MD

  3. University of Central Florida College of Medicine, Orlando, FL, USA

    H. Jack Baskin Sr MD, MACE

Authors
  1. Gregory Randolph MD, FACS
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  2. Barry Sacks MD
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  3. H. Jack Baskin Sr MD, MACE
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Corresponding author

Correspondence to Gregory Randolph MD, FACS .

Editor information

Editors and Affiliations

  1. University of Central Florida, North Orange Ave. 2921, Orlando, 32804, Florida, USA

    H. Jack Baskin, Sr.

  2. Endocrinology Associates, North 3rd Avenue 3522, Phoenix, 85613, Arizona, USA

    Daniel S. Duick

  3. Thyroid Center of New Hampshire, Coliseum Avenue 5, Nashua, 03063, New Hampshire, USA

    Robert A. Levine

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Randolph, G., Sacks, B., Baskin, H.J. (2013). Ultrasound and Mapping of Neck Lymph Nodes. In: Baskin, Sr., H., Duick, D., Levine, R. (eds) Thyroid Ultrasound and Ultrasound-Guided FNA. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4785-6_8

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  • DOI: https://doi.org/10.1007/978-1-4614-4785-6_8

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-4784-9

  • Online ISBN: 978-1-4614-4785-6

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