Clinicopathological and Radiological Evaluation of Cervical Lymph Node Metastasis in Head & Neck Malignancies

Abstract

Background: Head and neck cancers, highly prevalent in Asia and India, often present with cervical lymph node metastasis, impacting prognosis. This study evaluates the diagnostic accuracy of clinical examination, CT, ultrasonography, and pathological findings in detecting nodal metastasis, emphasizing imaging's role when clinical assessment is inconclusive.

Objectives: The objectives are to assess the role of radiological imaging, pathological results and clinical examination in evaluating cervical lymph node metastasis and to assess the diagnostic accuracy of radiological imaging when clinical examination produces negative results

Material methods: This cross-sectional study, conducted over 18 months in the Department of Otorhinolaryngology, included 157 patients with suspected head and neck malignancies. Patients aged 21–80 were included based on strict criteria. Radiological imaging was assessed using standardized criteria, and statistical analysis determined diagnostic accuracy.

Results: In this study involving 157 patients with suspected head and neck malignancies, oral cavity carcinoma was the most common diagnosis. Cervical lymph node metastasis was evaluated using clinical examination, CT, ultrasonography, and fine needle aspiration cytology, with histopathology serving as the reference standard. USG demonstrated the highest sensitivity (93.3%) for detecting metastasis, followed by FNAC (90%) and CT (83.3%).

Conclusion: This study emphasizes a multidisciplinary diagnostic approach for cervical lymph node metastasis in head and neck cancers. Ultrasound showed highest sensitivity, while CT provided anatomical precision. Combining clinical examination, USG, CT, FNAC, and histopathology enhances diagnostic accuracy, improves staging, guides treatment planning, and leads to better patient outcomes and prognosis.