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Cervical: Lymphadenopathy

  • Mahmoud Sakr
Chapter

Abstract

The neck region contains around 300 lymph nodes (LNs) out of 800 LNs in the whole body. The detailed study of LNs by Rouviere in 1932 [1] and the later illustration of metastatic predilection of head and neck malignancies to certain LN regions by Lindberg et al. [2] paved the road to a clinically sound classification. The American Academy of Otolaryngology and Head and Neck Surgery (AAO-HNS) and the American Joint Committee on Cancer (AJCC) developed the currently widely accepted levels classification of the cervical LNs (Table 8.1, Figs. 8.1 and 8.2).

Keywords

Kawasaki Disease Neck Dissection Cervical Lymphadenopathy Radical Neck Dissection Selective Neck Dissection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Rouvière H. Anatomie des lymphatiques de l’homme. Paris: Masson; 1932.Google Scholar
  2. 2.
    Lindberg R. Distribution of cervical lymph node metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer. 1972;29(6):1446–9. PubMed.CrossRefPubMedGoogle Scholar
  3. 3.
    Deschler DG, Moore MG, Smith RV. Quick reference guide to TNM staging of head and neck cancer and neck dissection classification, 4th ed. Alexandria: American Academy of Otolaryngology-Head and Neck Surgery Foundation; 2014.Google Scholar
  4. 4.
    Bocca E, Pignataro O, Oldini C, Cappa C. Functional neck dissection: an evaluation and review of 843 cases. Laryngoscope. 1984;94(7):942–5. PubMed.CrossRefPubMedGoogle Scholar
  5. 5.
    Gavilan C, Gavilan J. Five-year results of functional neck dissection for cancer of the larynx. Arch Otolaryngol Head Neck Surg. 1989;115(10):1193–6. PubMed.CrossRefPubMedGoogle Scholar
  6. 6.
    Shah JP. Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. Am J Surg. 1990;160(4):405–9. PubMed.CrossRefPubMedGoogle Scholar
  7. 7.
    Robbins KT. Classification of neck dissection: current concepts and future considerations. Otolaryngol Clin North Am. 1998;31(4):639–55. PubMed.CrossRefPubMedGoogle Scholar
  8. 8.
    Ferlito A, Rinaldo A, Robbins KT, Silver CE. Neck dissection: past, present and future? J Laryngol Otol. 2006;120(2):87–92. PubMed.CrossRefPubMedGoogle Scholar
  9. 9.
    Robbins KT, Clayman G, Levine PA, Medina J, Sessions R, Shaha A, et al. Neck dissection classification update: revisions proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery. Arch Otolaryngol Head Neck Surg. 2002;128(7):751–8. PubMed.CrossRefPubMedGoogle Scholar
  10. 10.
    Robbins KT, Medina JE, Wolfe GT, Levine PA, Sessions RB, Pruet CW. Standardizing neck dissection terminology. Official report of the Academy’s Committee for Head and Neck Surgery and Oncology. Arch Otolaryngol Head Neck Surg. 1991;117(6):601–5. PubMed.CrossRefPubMedGoogle Scholar
  11. 11.
    Robbins KT, Shaha AR, Medina JE, Califano JA, Wolf GT, Ferlito A, et al. Consensus statement on the classification and terminology of neck dissection. Arch Otolaryngol Head Neck Surg. 2008;134(5):536–8. PubMed.CrossRefPubMedGoogle Scholar
  12. 12.
    Mohseni S, Shojaiefard A, Khorgami Z, Alinejad S, Ghorbani A, Ghafouri A. Peripheral lymphadenopathy: approach and diagnostic tools. Iran J Med Sci. 2014;39(2 Suppl):158–70. PubMed.PubMedCentralPubMedGoogle Scholar
  13. 13.
    Sambandan T, Christeffe Mabel R. Cervical lymphadenopathy-a review. JIADS. 2011;2(1):31–3.Google Scholar
  14. 14.
    Bazemore AW, Smucker DR. Lymphadenopathy and malignancy. Am Fam Physician. 2002;66(11):2103–10.PubMedGoogle Scholar
  15. 15.
    Parisi E, Glick M. Cervical lymphadenopathy in the dental patient: a review of clinical approach. Quintessence Int. 2005;36(6):423–36.PubMedGoogle Scholar
  16. 16.
    Campo E, Swerdlow SH, Harris NL, Pileri S, Stein H, Jaffe ES. The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood. 2011;117(19):5019–32.PubMedCentralCrossRefPubMedGoogle Scholar
  17. 17.
    McPhail E, Kurtin P. Lymph node. In: Cheng L, Bostwick DG, editors. Essentials of anatomic pathology. New York: Springer; 2011. p. 681–721.CrossRefGoogle Scholar
  18. 18.
    Karnath BM. Approach to the patient with lymphadenopathy. Hosp Physician. 2005;41(7):29.Google Scholar
  19. 19.
    Biswas G, Das A, Haldar D, Mukherjee A, Dutta S, Sinha R. Clinico-pathological correlates of cervical lymphadenopathy: a hospital based study. Indian J Otolaryngol Head Neck Surg. 2013;65(1):42–7.PubMedCentralCrossRefPubMedGoogle Scholar
  20. 20.
    Upadhyay N. Cervical lymphadenopathy. J Dental Sci. 2012;30–33.Google Scholar
  21. 21.
    Gosche JR, Vick L. Acute, subacute, and chronic cervical lymphadenitis in children. Semin Pediatr Surg. 2006;15(2):99–106. PubMed.CrossRefPubMedGoogle Scholar
  22. 22.
    Ebell MH. Epstein-Barr virus infectious mononucleosis. Am Fam Physician. 2004;70(7):1279–87. PubMed Epub 2004/10/29. eng.PubMedGoogle Scholar
  23. 23.
    Jha B, Dass A, Nagarkar N, Gupta R, Singhal S. Cervical tuberculous lymphadenopathy: changing clinical pattern and concepts in management. Postgrad Med J. 2001;77(905):185–7.PubMedCentralCrossRefPubMedGoogle Scholar
  24. 24.
    Wahid F, Afridi H, Javaid M, Khan Q, Shahabi I. Tuberculous cervical lymphadenopathy: FNAC based study of 100 cases J Med Sci. 2011;19(3):119–121Google Scholar
  25. 25.
    Khan JA, Mehboob M, Wadood E, Qayyum A, Arbab G. Tuberculous cervical lymphadenopathy. J Surg Pak. 2001;6:16–8.Google Scholar
  26. 26.
    Eshete A, Zeyinudin A, Ali S, Abera S, Mohammed M. M. tuberculosis in lymph node biopsy Paraffin-embedded sections. Tubercul Res Treat. 2011;8:1–5.Google Scholar
  27. 27.
    Jones P, Campbell P. Tuberculous lymphadenitis in childhood: the significance of anonymous mycobacteria. Br J Surg. 1962;50(221):302–14.CrossRefPubMedGoogle Scholar
  28. 28.
    Mohapatra PR, Janmeja AK. Tuberculous lymphadenitis. J Assoc Physicians India. 2009;57:585–90.PubMedGoogle Scholar
  29. 29.
    Thiagarajan B, Punniyakodi K. Collar stud abscess an interesting case report. Otolaryngol Online J. 2012;2(2). ISSN2250-0359Google Scholar
  30. 30.
    Sato J, Tsubota H, Himi T. Syphilitic cervical lymphadenopathy. Eur Arch Otorhinolaryngol. 2003;260(5):283–5. English.Google Scholar
  31. 31.
    Wang X, Li WQ, Liu HM, Yan HZ, Li YM, He J, et al. Isolated syphilitic cervical lymphadenopathy: report of two cases and review of the literature. J Int Med Res. 2012;40(5):1988–2000. PubMed Epub 2012/12/05. eng.CrossRefPubMedGoogle Scholar
  32. 32.
    Ridder GJ, Boedeker CC, Technau-Ihling K, Grunow R, Sander A. Role of cat-scratch disease in lymphadenopathy in the head and neck. Clin Infect Dis. 2002;35(6):643–9. PubMed Epub 2002/08/31. eng.CrossRefPubMedGoogle Scholar
  33. 33.
    Kale US, Carlin J. Toxoplasmosis as a rare cause of symptomatic cervical lymphadenopathy. Indian J Otolaryngol Head Neck Surg. 2000;52(3):261–3. PubMed.PubMedCentralPubMedGoogle Scholar
  34. 34.
    Shakya K, Shakya G, Malla S, Shrestha R. A study of FNACE of cervical lymph nodes. J Nepal Health Res Council. 2009;7(1):49–51.Google Scholar
  35. 35.
    Sheykholeslami1 K, Alcantara M , Khan A, Laib D. Asymptomatic neck mass as the only presenting symptom of advanced prostate cancer, a case report and literature review. J Otol Rhinol 2013,2:2. http://dx.doi.org/10.4172/2324-8785.1000117
  36. 36.
    Alam K, Khan A, Siddiqui F, Jain A, Haider N, Maheshwari V. Fine needle aspiration cytology (FNAC), a handy tool for metastatic lymphadenopathy. Intern J Pathol. 2010;10(2):1528–8307.Google Scholar
  37. 37.
    Naeimi M, Sharifi A, Erfanian Y, Velayati A, Izadian S, Golparvar S. Differential diagnosis of cervical malignant lymphadenopathy among Iranian patients. Saudi Med J. 2009;30(3):377–81.PubMedGoogle Scholar
  38. 38.
    Magsi PB, Jamro BU, Shaikh AA, Sangi HA. An audit of 140 cases of cervical lymphadenopathy at tertiary care hospital. Gomal J Med Sci. 2013;11(1): 47–49.Google Scholar
  39. 39.
    Lukić S, Marjanović G, Živanović J. Palpable lymphadenopathy in primary care. Acta Facultatis Medicae Naissensis. 2011;28(1):17–23.Google Scholar
  40. 40.
    Mogre D. Chronic cervical lymphadenopathy: a clinicopathological profile. Paripex-Indian J Res. 2014;3(12):19–24.Google Scholar
  41. 41.
    Calguneri M, Ozturk MA, Ozbalkan Z, Akdogan A, Ureten K, Kiraz S, et al. Frequency of lymphadenopathy in rheumatoid arthritis and systemic lupus erythematosus. J Int Med Res. 2003;31(4):345–9. PubMed Epub 2003/09/11. eng.CrossRefPubMedGoogle Scholar
  42. 42.
    Benaglio F, Vitolo B, Scarabelli M, Binda E, Bugatti S, Caporali R, et al. The draining lymph node in rheumatoid arthritis: current concepts and research perspectives. BioMed Res Int. 2014;12:1–10.Google Scholar
  43. 43.
    Richner S, Laifer G. Peripheral lymphadenopathy in immunocompetent adults. Swiss Med Wkly. 2010;140(7–8):98–104.PubMedGoogle Scholar
  44. 44.
    Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthrit Rheumat. 2010;62(9):2569–81.CrossRefGoogle Scholar
  45. 45.
    Feletar M, Ibañez D, Urowitz MB, Gladman DD. The impact of the 1997 update of the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus: what has been changed? Arthrit Rheumat. 2003;48(7):2067–9.CrossRefGoogle Scholar
  46. 46.
    Shiboski S, Shiboski C, Criswell L, Baer A, Challacombe S, Lanfranchi H, et al. American College of Rheumatology classification criteria for Sjögren’s syndrome: a data‐driven, expert consensus approach in the Sjögren’s International Collaborative Clinical Alliance Cohort. Arthritis Care Res. 2012;64(4):475–87.CrossRefGoogle Scholar
  47. 47.
    Sahlmann CO, Meller J, Siggelkow H, Homayounfar K, Ozerden M, Braune I, et al. Patients with autoimmune thyroiditis. Prevalence of benign lymphadenopathy. Nuklearmedizin. 2012;51(6):223–7. PubMed Epub 2012/10/09. eng.CrossRefPubMedGoogle Scholar
  48. 48.
    Paksoy N, Yazal K. Cervical lymphadenopathy associated with Hashimoto’s thyroiditis: an analysis of 22 cases by fine needle aspiration cytology. Acta Cytol. 2009;53(5):491–6. PubMed Epub 2009/10/06. eng.CrossRefPubMedGoogle Scholar
  49. 49.
    Dutta MK, Gundgurthi A, Garg MK, Kotwal N. Juvenile Graves’ disease with ophthalmopathy, lymphadenopathy, accelerated growth and congestive cardiac failure. Indian J Pediatr. 2012;79(5):670–2. PubMed Epub 2011/06/28. eng.CrossRefPubMedGoogle Scholar
  50. 50.
    Rodriguez MC, Rani D, Faas FH. Unusual clinical course of Graves’ thyrotoxicosis and concomitant sarcoidosis: case report and review of literature. Endocr Pract. 2007;13(2):159–63. PubMed Epub 2007/05/11. eng.CrossRefPubMedGoogle Scholar
  51. 51.
    Kanwar JB, Gupta S, Agarwal A, Gupta A. Adrenal lymphoma: case report and review of literature. World J Endocrine Surg. 2010;2(1):39–43.CrossRefGoogle Scholar
  52. 52.
    Rashidi A, Fisher S. Primary adrenal lymphoma: a systematic review. Ann Hematol. 2013;92(12):1583–93. English.Google Scholar
  53. 53.
    Danno K, Kume M, Ohta M, Utani A, Ohno S, Kobashi Y. Erythroderma with generalized lymphadenopathy induced by phenytoin. J Dermatol. 1989;16(5):392–6. PubMed Epub 1989/10/01. eng.CrossRefPubMedGoogle Scholar
  54. 54.
    Brown JR, Skarin AT. Clinical mimics of lymphoma. Oncologist. 2004;9(4):406–16.CrossRefPubMedGoogle Scholar
  55. 55.
    Johns ME, Moscinski LC, Sokol L. Phenytoin-associated lymphoadenopathy mimicking a peripheral T-cell lymphoma. Mediterranean J Hematol Infect Dis. 2010;2(2):e2010028.Google Scholar
  56. 56.
    Yanagi S, Nomura Y, Masuda K, Koriyama C, Sameshima K, Eguchi T, et al. Early diagnosis of Kawasaki disease in patients with cervical lymphadenopathy. Pediatr Int. 2008;50(2):179–83.CrossRefPubMedGoogle Scholar
  57. 57.
    Yokouchi Y, Oharaseki T, Harada M, Ihara F, Naoe S, Takahashi K. Histopathological study of lymph node lesions in the acute phase of Kawasaki disease. Histopathology. 2013;62(3):387–96.CrossRefPubMedGoogle Scholar
  58. 58.
    Lee K-Y, Rhim J-W, Kang J-H. Kawasaki disease: laboratory findings and an immunopathogenesis on the premise of a. Yonsei Med J. 2012;53(2):262–75.PubMedCentralCrossRefPubMedGoogle Scholar
  59. 59.
    Kwon YS, Jung HI, Kim HJ, Lee JW, Choi W-I, Kim JY, et al. Isolated cervical lymph node sarcoidosis presenting in an asymptomatic neck mass: a case report. Tuberculos Respirat Dis. 2013;75(3):116–9. PubMed.CrossRefGoogle Scholar
  60. 60.
    Chen HC, Kang BH, Lai CT, Lin YS. Sarcoidal granuloma in cervical lymph nodes. J Chin Med Assoc. 2005;68(7):339–42. PubMed Epub 2005/07/26. eng.CrossRefPubMedGoogle Scholar
  61. 61.
    Khanna R, Sharma AD, Khanna S, Kumar M, Shukla RC. Usefulness of ultrasonography for the evaluation of cervical lymphadenopathy. World J Surg Oncol. 2011;9:29.PubMedCentralCrossRefPubMedGoogle Scholar
  62. 62.
    Mahajan T, Merriman RC, Stone MJ. Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenitis): report of a case with other autoimmune manifestations. Proceedings (Baylor University Medical Center). 2007;20(2):149–51. PubMed.Google Scholar
  63. 63.
    Sudha A, Vivekanand N. Cytologic picture of Castleman’s disease: a report of two cases. J Cytol/Indian Acad Cytolog. 2010;27(4):152–4. PubMed.CrossRefGoogle Scholar
  64. 64.
    Nishi J, Maruyama I. Increased expression of vascular endothelial growth factor (VEGF) in Castleman’s disease: proposed pathomechanism of vascular proliferation in the affected lymph node. Leuk Lymphoma. 2000;38(3–4):387–94. PubMed Epub 2000/06/01. eng.CrossRefPubMedGoogle Scholar
  65. 65.
    Briasoulis E, Tolis C, Bergh J, Pavlidis N, Force EGT. ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of cancers of unknown primary site (CUP). Ann Oncol. 2005;16 Suppl 1:i75–6. PubMed.CrossRefPubMedGoogle Scholar
  66. 66.
    Saghatchian M, Fizazi K, Borel C, Ducreux M, Ruffie P, Le Chevalier T, et al. Carcinoma of an unknown primary site: a chemotherapy strategy based on histological differentiation – results of a prospective study. Ann Oncol. 2001;12(4):535–40. PubMed.CrossRefPubMedGoogle Scholar
  67. 67.
    Abbruzzese JL, Abbruzzese MC, Hess KR, Raber MN, Lenzi R, Frost P. Unknown primary carcinoma: natural history and prognostic factors in 657 consecutive patients. J Clin Oncol. 1994;12(6):1272–80. PubMed.PubMedGoogle Scholar
  68. 68.
    Strojan P, Anicin A. Combined surgery and postoperative radiotherapy for cervical lymph node metastases from an unknown primary tumour. Radiother Oncol. 1998;49(1):33–40. PubMed.CrossRefPubMedGoogle Scholar
  69. 69.
    Vaamonde P, Martin Martin C, del Rio Valeiras M, Labella Caballero T. A study of cervical metastases from unknown primary tumor. Acta Otorrinolaringol Esp. 2002;53(8):601–6. PubMed Estudio sobre las metastasis cervicales de primario desconocido.CrossRefPubMedGoogle Scholar
  70. 70.
    Leung AK, Kellner JD. Group A beta-hemolytic streptococcal pharyngitis in children. Adv Ther. 2004;21(5):277–87. PubMed.CrossRefPubMedGoogle Scholar
  71. 71.
    Ferrer R. Lymphadenopathy: differential diagnosis and evaluation. Am Fam Physician. 1998;58(6):1313–20. PubMed.PubMedGoogle Scholar
  72. 72.
    Kozuch P GM. Lymphadenopathy. Clinical hematology and oncology. New York: Churchill Livingstone; 2003. p. 213–20.Google Scholar
  73. 73.
    Lee Y, Terry R, Lukes RJ. Lymph node biopsy for diagnosis: a statistical study. J Surg Oncol. 1980;14(1):53–60. PubMed.CrossRefPubMedGoogle Scholar
  74. 74.
    Lister TA, Crowther D. Staging for Hodgkin’s disease. Semin Oncol. 1990;17(6):696–703. PubMed.PubMedGoogle Scholar
  75. 75.
    Chau I, Kelleher MT, Cunningham D, Norman AR, Wotherspoon A, Trott P, et al. Rapid access multidisciplinary lymph node diagnostic clinic: analysis of 550 patients. Br J Cancer. 2003;88(3):354–61. PubMed Pubmed Central PMCID: 2747551.PubMedCentralCrossRefPubMedGoogle Scholar
  76. 76.
    Ellison E, LaPuerta P, Martin SE. Supraclavicular masses: results of a series of 309 cases biopsied by fine needle aspiration. Head Neck. 1999;21(3):239–46. PubMed.CrossRefPubMedGoogle Scholar
  77. 77.
    Steel BL, Schwartz MR, Ramzy I. Fine needle aspiration biopsy in the diagnosis of lymphadenopathy in 1,103 patients. Role, limitations and analysis of diagnostic pitfalls. Acta Cytol. 1995;39(1):76–81. PubMed.PubMedGoogle Scholar
  78. 78.
    Habermann TM, Steensma DP. Lymphadenopathy. Mayo Clin Proc. 2000;75(7):723–32. PubMed.CrossRefPubMedGoogle Scholar
  79. 79.
    Ahuja AT, Ying M. Sonographic evaluation of cervical lymph nodes. Am J Roentgenol. 2005;184(5):1691–9.CrossRefGoogle Scholar
  80. 80.
    Ahuja A, Ying M. Sonography of neck lymph nodes. Part II: abnormal lymph nodes. Clin Radiol. 2003;58(5):359–66. PubMed Epub 2003/05/03. eng.CrossRefPubMedGoogle Scholar
  81. 81.
    van den Brekel MW, Castelijns JA, Stel HV, Golding RP, Meyer CJ, Snow GB. Modern imaging techniques and ultrasound-guided aspiration cytology for the assessment of neck node metastases: a prospective comparative study. Eur Arch Otorhinolaryngol. 1993;250(1):11–7. PubMed Epub 1993/01/01. eng.CrossRefPubMedGoogle Scholar
  82. 82.
    Ying M, Ahuja AT, Evans R, King W, Metreweli C. Cervical lymphadenopathy: sonographic differentiation between tuberculous nodes and nodal metastases from non-head and neck carcinomas. J Clin Ultrasound. 1998;26(8):383–9. PubMed Epub 1998/10/23. eng.CrossRefPubMedGoogle Scholar
  83. 83.
    Asai S, Miyachi H, Suzuki K, Shimamura K, Ando Y. Ultrasonographic differentiation between tuberculous lymphadenitis and malignant lymph nodes. J Ultrasound Med. 2001;20(5):533–8. PubMed Epub 2001/05/10. eng.PubMedGoogle Scholar
  84. 84.
    Ahuja A, Ying M, Yuen YH, Metreweli C. Power Doppler sonography to differentiate tuberculous cervical lymphadenopathy from nasopharyngeal carcinoma. AJNR Am J Neuroradiol. 2001;22(4):735–40. PubMed Epub 2001/04/06. eng.PubMedGoogle Scholar
  85. 85.
    Ahuja AT, Ying M, Yuen HY, Metreweli C. ‘Pseudocystic’ appearance of non-Hodgkin’s lymphomatous nodes: an infrequent finding with high-resolution transducers. Clin Radiol. 2001;56(2):111–5. PubMed Epub 2001/02/27. eng.CrossRefPubMedGoogle Scholar
  86. 86.
    Ahuja A, Ying M. Sonographic evaluation of cervical lymphadenopathy: is power Doppler sonography routinely indicated? Ultrasound Med Biol. 2003;29(3):353–9. PubMed Epub 2003/04/23. eng.CrossRefPubMedGoogle Scholar
  87. 87.
    O’Brien CJ, Smith JW, Soong SJ, Urist MM, Maddox WA. Neck dissection with and without radiotherapy: prognostic factors, patterns of recurrence, and survival. Am J Surg. 1986;152(4):456–63. PubMed Epub 1986/10/01. eng.CrossRefPubMedGoogle Scholar
  88. 88.
    Johnson JT, Barnes EL, Myers EN, Schramm Jr VL, Borochovitz D, Sigler BA. The extracapsular spread of tumors in cervical node metastasis. Arch Otolaryngol. 1981;107(12):725–9. PubMed Epub 1981/12/01. eng.CrossRefPubMedGoogle Scholar
  89. 89.
    Chong V. Cervical lymphadenopathy: what radiologists need to know. Cancer Imaging. 2004;4(2):116.PubMedCentralCrossRefPubMedGoogle Scholar
  90. 90.
    Leemans CR, Tiwari R, Nauta JJ, van der Waal I, Snow GB. Regional lymph node involvement and its significance in the development of distant metastases in head and neck carcinoma. Cancer. 1993;71(2):452–6. PubMed Epub 1993/01/15. eng.CrossRefPubMedGoogle Scholar
  91. 91.
    Kaji AV, Mohuchy T, Swartz JD. Imaging of cervical lymphadenopathy. Semin Ultrasound CT MR. 1997;18(3):220–49. PubMed Epub 1997/06/01. eng.CrossRefPubMedGoogle Scholar
  92. 92.
    Screaton NJ, Berman LH, Grant JW. Head and neck lymphadenopathy: evaluation with US-guided cutting-needle biopsy. Radiology. 2002;224(1):75–81. PubMed.CrossRefPubMedGoogle Scholar
  93. 93.
    Southam J, Bradley P, Musgrove B. Fine needle cutting biopsy of lesions of the head and neck. Br J Oral Maxillofac Surg. 1991;29(4):219–22.CrossRefPubMedGoogle Scholar
  94. 94.
    Ducci M, Appetecchia M, Marzetti M. Neck dissection for surgical treatment of lymph node metastasis in papillary thyroid carcinoma. J Exp Clin Cancer Res. 1997;16(3):333–5. PubMed Epub 1997/12/05. eng.PubMedGoogle Scholar
  95. 95.
    Grénman R. Principles and Techniques of Neck Dissection. In: Anniko M, Bernal-Sprekelsen M, Bonkowsky V, Bradley P, Iurato S, editors. Otorhinolaryngology, head and neck surgery. European manual of medicine. Berlin/Heidelberg: Springer; 2010.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Head and Neck and Endocrine Surgery, Faculty of MedicineAlexandria UniversityAlexandriaEgypt

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