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Diagnostic Pathology: Lymph Nodes And Extranoda...
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Presents concise, extensive, and up-to-date information on more than 120 benign and malignant lesions of the lymph nodes, and covers extranodal lymphomas to help new and experienced surgical pathologists and hematopathologists alike identify crucial elements of each diagnosis and associated differential diagnoses
Purpose/objectives: Extranodal extension (ENE) and more than 4 pathologically involved lymph nodes (pN2) are critical prognostic factors in HPV-associated oropharyngeal cancer (HPV(+) OPSCC). We analyze a patient cohort with HPV(+) OPSCC to determine the sensitivity and specificity of CT and PET/CT in identifying involvement of more than 4 lymph nodes (rN2) compared to pN2 and radiographic ENE (rENE) compared to pathologic ENE (pENE).
Results: CT demonstrated sensitivity of 59%, specificity of 92%, positive predictive value (PPV) of 53%, negative predictive value (NPV) of 94%, and accuracy of 88% for pN2. PET/CT showed similar results. Patients with up to 4 involved lymph nodes (rN0-1) had a 93-94% chance of remaining pN0-1. CT and PET/CT identified an equal number of involved nodes in 81% of patients. CT demonstrated sensitivity of 54%, specificity of 71%, PPV of 72%, NPV of 53%, and accuracy of 62% for pENE. PET/CT showed similar outcomes. Notably, when multiple radiographic criteria were used to identify rENE, PPV increased for both CT (84%) and PET/CT (79%).
Covering all aspects of benign and malignant lesions of lymph nodes, and extranodal lymphomas, as well as malignancies of spleen, it incorporates the most recent clinical, pathologic, and molecular knowledge in this challenging field to provide a comprehensive overview of all key issues relevant to today's practice. 59ce067264