This report describes the correlation between sonographic (10MHz high-resolution) and pathologic findings of metastatic cervical lymph nodes in patients with oral squamous cell carcinoma. Pathological findings of primary lesions obtained by biopsy before any treatments were initiated were also correlated with those of metastatic lymph nodes. The study cohort consisted of 25 patients with oral squamous cell carcinoma admitted to our institution from April 1991 through July 1995, and 58 metastatic cervical lymph nodes obtained by neck dissection. The results were as follows. 1) A hyperechoic area seen on metastatic lymph nodes was derived from high keratinization. 2) The degree of keratinization of primary lesions was similar to that of metastatic lymph nodes. 3) Metastatic lymph nodes obtained in patients in whom primary lesions showed minimal or no keratinization had tendency to show hypoechoic or anechoic densities. 4) Metastatic lymph nodes obtained in patients in whom primary lesions showed high or moderate keratinization disclosed hyperechoic or heterogeneous densities. Our results suggest that the degree of keratinization of primary lesions might predict sonographic findings of metastatic cervical lymph nodes.
