Veterans Affairs Palo Alto Health Care System, Palo Alto and Department of Radiology, Stanford University School of Medicine, Stanford, California, USA.
J Ultrasound Med. 2009 Dec;28(12):1703-7. doi: 10.7863/jum.2009.28.12.1703.
The purpose of this series was to show the sonographic appearance of calcified cervical lymph nodes and the utility of sonographically guided fine-needle aspiration biopsy (FNAB) in the setting of metastatic squamous cell carcinoma (SCC).
Two cases of confirmed metastatic SCC to cervical lymph nodes were identified. Sonography and sonographically guided FNAB were performed in both cases with positron emission tomography (PET)/computed tomography (CT) correlation.
In case 1, sonography identified a diffusely calcified, avascular cervical lymph node. Positron emission tomography/CT suggested granulomatous disease as a cause for hypermetabolism; however, sonographically guided FNAB identified metastatic SCC. In the second case, FNAB initially performed without sonographic guidance did not show malignancy. Subsequent FNAB with sonographic guidance identified an abnormal cervical lymph node with focal calcifications and internal color Doppler flow. Metastatic SCC was diagnosed on histopathologic examination. Subsequent PET/CT confirmed multiple punctate calcifications in a hypermetabolic lymph node.
Calcifications in cervical lymph nodes from metastatic SCC are very rare. These 2 cases show the variable sonographic appearances and the utility of sonographically guided FNAB in establishing the correct diagnosis.
本系列旨在展示钙化性颈淋巴结的超声表现，以及超声引导下细针抽吸活检（FNAB）在转移性鳞状细胞癌（SCC）中的应用价值。
本研究共纳入 2 例经证实的转移性 SCC 颈淋巴结病例。对这 2 例病例均进行了超声和超声引导下 FNAB 检查，并与正电子发射断层扫描（PET）/计算机断层扫描（CT）进行了相关性分析。
在病例 1 中，超声检查发现一个弥漫性钙化、无血管的颈淋巴结。PET/CT 提示为肉芽肿性疾病导致代谢亢进；然而，超声引导下 FNAB 发现了转移性 SCC。在病例 2 中，首次进行的无超声引导的 FNAB 未显示恶性肿瘤。随后进行的超声引导 FNAB 发现一个异常的颈淋巴结，有局灶性钙化和内部彩色多普勒血流。组织病理学检查诊断为转移性 SCC。随后的 PET/CT 证实了代谢亢进的淋巴结中有多个点状钙化。
转移性 SCC 引起的颈淋巴结钙化非常罕见。这 2 个病例显示了不同的超声表现，以及超声引导下 FNAB 在明确诊断中的应用价值。
