The Role of Ultrasound-guided Cytology of Groin Lymph Nodes in the Management of Squamous Cell Carcinoma of the Vulva: 5-Year Experience in 44 Patients

• Published in: Clinical radiology Vol. 58; no. 5; pp. 367 - 371
• Main Authors: Hall, T.B, Barton, D.P.J, Trott, P.A, Nasiri, N, Shepherd, J.H, Thomas, J.M, Moskovic, E.C
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.05.2003; Elsevier
• Subjects: Biological and medical sciences; biopsy; Biopsy, Needle - methods; carcinoma; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - pathology; Female; Female genital diseases; Groin - diagnostic imaging; Gynecology. Andrology. Obstetrics; Humans; lymph node; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphatic Metastasis - diagnostic imaging; Lymphatic Metastasis - pathology; Medical sciences; Sensitivity and Specificity; Tumors; Ultrasonography, Interventional; ultrasound; vulva; Vulvar Neoplasms - diagnostic imaging; Vulvar Neoplasms - pathology; biopsy; carcinoma; vulva; lymph node; ultrasound; Sonography; Human; Squamous cell carcinoma; Lymph node; Aspiration; Cytology; Vulva; Inguinal; Metastasis; Method; Female genital diseases; Lymphatic vessel disease; Guidance; Accuracy; Fine needle; Echography; Vulvar diseases; Complication; Female; Diagnosis
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/S0009-9260(02)00575-5

AIM: To assess the accuracy of ultrasound combined with fine-needle aspiration cytology (FNAC) in the detection of lymph node metastasis in patients with squamous cell carcinoma of the vulva. MATERIALS AND METHODS: The groin nodes of 44 consecutive patients with primary squamous cell carcinoma of the vulva undergoing groin node dissection were assessed with ultrasound and FNAC. The results were compared with histology from subsequent inguinofemoral lymph node dissection. Twenty-nine patients underwent bilateral groin node dissections and 15 unilateral providing comparable data for 73 groins. RESULTS: Histology demonstrated metastatic disease in 28 groins and no evidence of metastatic disease in 45. Ultrasound agreed with the histology in 67 of the 73 groins (92%), with two false-positives, four false-negatives and two indeterminate appearances. Cytology agreed with the histology in 65 of 72 FNAC samples obtained (90%), with six false-negatives, and one indeterminate result. No false-positive cytology results were seen. Ultrasound and FNAC together failed to detect metastatic disease in four groins, one with an indeterminate ultrasound appearance, another with indeterminate cytology, the two others each having a single positive inguinal node despite a negative ultrasound and FNAC. CONCLUSION: The combination of ultrasound and FNAC provides a sensitive and specific tool for pre-operative assessment and may prevent unnecessary groin dissection and the attendant morbidity in selected patients with vulval cancer.