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Enlarged cervical lymph nodes may signal thyroid cancer

Issue: December 2011

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Annual Meeting of the ATA

INDIAN WELLS, Calif. - The appearance of enlarged cervical lymph nodes on ultrasound boosted the predictive value of diagnosing thyroid cancer in suspicious nodules, according to data presented here.

Although easy to spot during ultrasonographic assessment of thyroid nodules, the relationship between enlarged cervical lymph nodes and risk for thyroid cancer remains unknown, researchers at the Tulane University School of Medicine in New Orleans said.

To investigate a potential association, the researchers reviewed the charts of 257 patients referred for surgical evaluation of suspicious thyroid nodules and who underwent comprehensive ultrasound assessment. They found 198 patients who required surgical intervention and 59 who did not meet the criteria for thyroidectomy, seven of whom had enlarged cervical lymph nodes. The researchers included only patients with postoperative reports of papillary thyroid cancer or benign thyroid pathology. Of these 198 patients, 46 had papillary cancer. Enlarged cervical nodes were identified in 30 of the patients who underwent surgery.

Compared with 18 patients with thyroid cancer, only 12 with benign pathology had enlarged cervical lymph nodes (P<.001), according to study results. After analysis, the researchers concluded that the presence of these enlarged nodes had a positive predictive value of 60% and a negative predictive value of 82.4% in predicting thyroid cancer. Sensitivity was 39.1% and specificity was 91.6%, data indicated.

"Assessment of enlarged cervical lymph nodes by ultrasound is feasible and should be studied further to determine the exact clinical and pathologic implications of enlarged cervical lymph nodes found on preoperative ultrasound," the researchers wrote. "In our cohort, the presence of enlarged cervical lymph nodes increases the predictive value in diagnosing thyroid cancer in suspicious thyroid nodules."

For more information:

• Kniery KR. Oral 2. Presented at: the 81st Annual Meeting of the American Thyroid Association; Oct. 26-30, 2011; Indian Wells, Calif.

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