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How to detect metastasis of lymph nodes

Lymph node metastasis is common in thyroid cancers. A patient with a pre-operative thyroid cancer should be evaluated with a good ultrasonographic examination of the neck.

Ultrasonography detects the lymph node metastases in the neck and suspect arises.  Biopsy is performed and the diagnosis is confirmed.  A more practical method than biopsy, "Lymph Node Thyroglobulin Measurement" is usually used. Tg level is measured in papillary carcinomas, calcitonin is measured in medullary cancers.

While the thyroid glands are being removed, suspicious lymph nodes can be detected in the neck during surgery.  Pathologic examination (frozen) may be necessary during surgery if metastasis is suspected.

Elevated levels of Tg during the follow-up of a patient after the surgery suggests potential lymph metastasis in the foreground.  The patient is examined by ultrasonography and, if necessary, by other examinations.