Metastatic Adenocarcinoma to the Cervical Lymph Node: A Significant Proportion of Cholangiocarcinoma in Thai Patients

Abstract

<br/><b>Objective</b>: To determine distribution of the primary site of metastatic adenocarcinoma to the cervical lymphnode in Thai population with histological correlation. Materials and <br/><b>Methods</b>: 72 Thai patients with metastaticadenocarcinoma to the cervical lymph node were retrospectively analyzed. <br/><b>Results</b>: Thyroid gland (papillarycarcinoma) was the commonest source of tumor (41%), followed by lung (25%), bile duct (17%) and breast(7%). Metastatic cholangiocarcinoma typically produced distinct glandular pattern, and frequently involvedthe right supraclavicular lymph node. Brush border of the gland-forming tumor cells was a consistent finding inmetastatic cholangiocarcinoma, with 100% sensitivity and 97% specificity. <br/><b>Conclusions</b>: Cholangiocarcinomarepresents a significant portion of primary tumor in Thai patients with cervical nodal metastasis. This figuremay hold true for countries where bile duct malignancy is endemic, and may be of clinical usefulness inidentification of primary cancer.