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Metastatic Squamous Cell Carcinoma Presenting as Diffuse and Punctate Cervical Lymph Node Calcifications
Author(s) -
Shin Lewis K.,
Fischbein Nancy J.,
Kaplan Michael J.,
Jeffrey R. Brooke
Publication year - 2009
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2009.28.12.1703
Subject(s) - medicine , lymph node , radiology , cervical lymph nodes , lymph , metastatic carcinoma , malignancy , fine needle aspiration , biopsy , positron emission tomography , carcinoma , pathology , metastasis , cancer
Objective. 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). Methods. 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. Results. 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. Conclusions. 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.