Correlation of clinical, radiological and histopathological cervical lymph node involvement in oral cancer

Mada Lakshmi Narayana, B. N. Kumarguru, Hameed Arafath A., Urvashi Gaur, P. Lakshmi, Addanki Lakshmi Sravani


Background: Lymph node metastasis is the most important factor in the prognosis of oral cancers and survival drops by 50% in the presence of malignant lymph nodes. Most of the lymph node enlargement in oral cancers is due to tumor-associated inflammation rather than metastasis. The aim and objectives of the study was to assess the enlarged reactive and positive cervical lymph nodes clinically and radiologically with the histopathology of neck nodes.

Methods: All the oral cancer patients were examined clinically for enlarged neck nodes and subjected to contrast-enhanced computed tomography (CECT) oral cavity and neck. In CECT, all the characteristics of nodes were recorded, and after neck dissection, all levels of lymph nodes were assessed histopathologically.  

Results: In our study, 24 patients were included; among them, 31 enlarged lymph nodes were seen clinically. CECT showed a total of 90 enlarged lymph nodes which includes 21 positive nodes. In histopathology 538 lymph nodes were isolated, and among them, only 32 lymph nodes were found to be positive for malignancy.

Conclusions: The detection rate of enlarged lymph nodes is more with histopathology than radiological and clinical examination. In our study, 94% of lymph node enlargement was proven to be reactive, which shows more tumor-associated inflammation.


Lymph nodes, Inflammation, Oral cancer, Metastasis

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