An immunohistochemical expression of CK5/6, CK7, and CK20 on cell blocks in metastatic cervical lymphadenopathy

Abstract

Background The neck is a common site of both primary and secondary malignancies. Many tumors from the head and neck (oral cavity, larynx, and pharynx), lung, and gastrointestinal tract metastasize to cervical lymph nodes. At most times, tumors are diagnosed by morphology, sometimes it is difficult to diagnose an unknown primary presenting as metastatic lymphadenopathy solely on the basis of morphology. Specific histological cell types can be confirmed by the use of immunohistochemistry. Aim The present study evaluated the utility of cell block over fine-needle aspiration cytology (FNAC) and immunohistochemical expression of CK5/6, CK7, and CK20 in metastatic cervical lymphadenopathy. Methods: This prospective study design was used on a total of 50 cases. FNAC smears and cell blocks were made in all the cases. All the cell blocks were compared with FNAC findings and further subjected to immunohistochemical (IHC) analysis. The necessary statistical analysis was done. Results and Conclusion Our study showed that the combined use of the cell block technique and FNAC was more useful and sensitive in diagnosing the metastatic cervical lymph nodes and the accuracy can be further improved by the use of IHC on the cell blocks. The combined use of CK5/6, CK7, and CK20 in metastatic cervical lymphadenopathy is helpful in diagnosing squamous cell carcinoma and adenocarcinoma with known/unknown primary sites.