ASSESSMENT OF OCCULT CERVICAL LYMPH NODE METASTASIS IN PRIMARY SQUAMOUS CELL CARCINOMA OF THE HEAD AND NECK BY COMPUTED TOMOGRAPHY

Assessment of Occult Lymph Node Metastasis

Abstract

Objectives: To determine the frequency of occult (node negative) cervical lymph node metastasis in primary head and neck squamous cell carcinoma, using contrast enhanced computed tomography (CT).

Study Design: Cross sectional descriptive study.

Place and Duration of Study: Study was conducted in Department of Radiology, Combined Military Hospital Rawalpindi. Duration of the study was 06 months i.e. from 19^th February 2011 to 19^th August 2011.

Patients and Methods: A total of 141 cases, fulfilling the ınclusion criteria, reporting to the radiology department, were included in the study after seeking written informed consent. All patients underwent contrast enhanced CT scan of the neck from base of skull to root of neck using Asteion Whole Body X-ray CT Scanner (Model TSX-021A). Images were evaluated for the presence or absence of cervical lymph node metastasis according to the cervical lymph node metastatic criteria at each level of the neck.

Results: Of the 141 patients with clinically no head and neck squamous cell carcinoma, 45.4% were found to have lymph node metastases. Frequency of occult metastases in squamous cell carcinoma of oral cavity was 47.6%, oropharynx 23.5%, larynx 33.3% and hypopharynx 78.6%.

Conclusion:  In clinically node negative neck, the risk of lymph node metastases is significantly high in patients of head and neck squamous cell carcinoma in our population. All patients presenting with node negative neck should undergo CT scans for early detection of occult metastasis.