[Diagnostic value of cervical lymph node biopsy in suspected nasopharyngeal cancer]

More than 90% of nasopharyngeal malignancies are carcinomas. Early symptoms are rare and usually ignored by the patients. The most common symptoms present are enlarged cervical nodes. More than half of all patients with nasopharyngeal carcinoma (58%) treated in the ENT-Clinic of the University of Munich had been admitted for further investigation because of cervical lymph node enlargement. Enlarged cervical lymph nodes can be removed easily. Thus the value of a lymph node biopsy for early diagnosis of nasopharyngeal carcinoma was examined. Forty-five cases of occult nasopharyngeal carcinomas have been reviewed. In all cases a cervical lymph node had been removed as a first diagnostic procedure. The histological findings were compared to nasopharyngeal biopsies taken after different time intervals. Our clinico-pathological review has shown that, especially in undifferentiated carcinoma, the histological features of cervical metastases is always identical to the very characteristic primary lesions in the nasopharynx. Thus, the characteristic feature of this tumour type in a jugulo-digastric lymph node strongly suggests the presence of a primary nasopharyngeal carcinoma.