Korean J Otorhinolaryngol-Head Neck Surg.  2014 Dec;57(12):841-846. 10.3342/kjorl-hns.2014.57.12.841.

Diagnostic Accuracy for Malignancy in Open Surgical Biopsy of Neck Lymph Nodes

• Ryu G
• Cho JK
• Jeong HS

• KMID: 1802428
• DOI: http://doi.org/10.3342/kjorl-hns.2014.57.12.841

Abstract

BACKGROUND AND OBJECTIVES
The open surgical biopsy (OSB) of neck lymph nodes is considered a definite diagnostic procedure; however, the diagnostic accuracy of this procedure has not been fully studied. Thus, we aimed to identify the false negative rates of OSB for malignancy and the possible causes of misdiagnosis that might severely affect patient prognosis.
SUBJECTS AND METHOD
We extracted the data from 495 OSB of neck lymph nodes between 2005 and 2012. The diagnostic accuracy of OSB of neck lymph nodes was estimated based on re-biopsy. In addition, we reviewed possible clinical factors related to false negativity, cause of misdiagnosis and its clinical impacts.
RESULTS
The false negative rate of OSB of neck nodes was 2.2% with a risk of 3.8% false diagnosis among subjects with initial 'benign' results. The cases of the initial misdiagnosis (n=7) had the dismal outcomes (4 deaths, 1 disease progression). The main cause of misdiagnosis was the failure to target the disease-affected lymph nodes (85.7%). Malignancy-related symptoms persisted in all cases of misdiagnosis, which required re-biopsy.
CONCLUSION
Accurate targeting of lymph nodes, close monitoring of clinical symptoms and comparison of biopsy results with symptoms are very important to reduce false negativity for malignancy in OSB of neck lymph nodes.

Keyword

Biopsy; Diagnosis; False negative reactions; Lymph nodes; Neoplasm

MeSH Terms

Biopsy*
Diagnosis
Diagnostic Errors
False Negative Reactions
Humans
Lymph Nodes*
Neck*
Prognosis