Objective: Accurate and timely diagnosis of cervical lymphadenopathy is essential for effective management. This study aimed to assess the diagnostic performance of various imaging modalities and biopsy techniques compared to surgical excisional lymph node biopsy (SEB). Material and Methods: A retrospective review of 115 patients who underwent SEB was performed. Preoperative diagnostic methods including fine-needle aspiration biopsy (FNAB), ultrasound-guided core needle biopsy (USCNB), ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography- CT (PET-CT) were evaluated for sensitivity, specificity, and concordance with SEB results. Results: Among 115 patients (61 males, 54 females; mean age 48.6±19 years), FNAB and USCNB were performed in 62 and 37 patients, respectively. Ultrasound identified pathological nodes in 71.3% of 82 patients but had a 31% false-positive rate. CT correctly diagnosed 66.6% of 30 patients, and MRI identified true positives in 53.8% of 39 patients. PET-CT achieved 83% true-positive results in 59 patients. USCNB matched SEB in 64.8% of cases, with a non-diagnostic rate of 21.6% and a 13.5% error rate. In malignancy detection, USCNB had a sensitivity of 90% and specificity of 77.7%, with 2 false positives and 2 false negatives. Conclusion: PET-CT and USCNB demonstrated high diagnostic accuracy in cervical lymphadenopathy. PET-CT achieved the highest correct diagnosis rate, while USCNB showed strong sensitivity and acceptable specificity. CT and MRI were less reliable, highlighting the need for clearer diagnostic protocols, particularly in cases involving lymphoma and other head and neck tumors.

Amaç: Servikal lenfadenopatinin doğru ve zamanında tanısı, etkili bir tedavi süreci için hayati öneme sahiptir. Bu çalışma, cerrahi eksizyonel lenf nodu biyopsisi (SEB) ile karşılaştırıldığında çeşitli görüntüleme yöntemleri ve biyopsi tekniklerinin tanısal doğruluğunu değerlendirmeyi amaçlamaktadır. Gereç ve Yöntem: SEB uygulanan 115 hastanın geriye dönük analizi yapıldı. İnce iğne aspirasyon biyopsisi (FNAB), ultrason eşliğinde yapılan kor biyopsi (USCNB), ultrason, bilgisayarlı tomografi (BT), manyetik rezonans görüntüleme (MRG) ve pozitron emisyon tomografi-BT (PET-BT) gibi preoperatif tanı yöntemleri; duyarlılık, özgüllük ve SEB sonuçlarıyla uyumluluk açısından değerlendirildi. Bulgular: 115 hastanın (61 erkek, 54 kadın; ortalama yaş 48,6±19 yıl) 62’sine FNAB, 37’sine USCNB uygulandı. Ultrason, 82 hastanın %71,3’ünde patolojik lenf nodlarını saptadı ancak %31 oranında yanlış pozitif sonuç verdi. BT, 30 hastanın %66,6’sında doğru tanı koydu; MRG ise 39 hastanın %53,8’inde doğru pozitif sonuç sağladı. PET-BT, 59 hastanın %83’ünde doğru pozitif sonuç verdi. USCNB, SEB ile %64,8 oranında uyum gösterdi; %21,6 oranında tanı konulamayan, %13,5 oranında ise hatalı sonuçlar izlendi. Malignite saptanmasında USCNB’nin duyarlılığı %90, özgüllüğü ise %77,7 olarak hesaplandı (2 yanlış pozitif, 2 yanlış negatif). Sonuç: PET-BT ve USCNB, servikal lenfadenopati tanısında yüksek doğruluk oranları sergilemiştir. PET-BT en yüksek doğru tanı oranına ulaşırken, USCNB yüksek duyarlılık ve kabul edilebilir özgüllük sunmuştur. BT ve MRG ise daha düşük güvenilirliğe sahiptir. Özellikle lenfoma ve diğer baş-boyun tümörleri vakalarında daha net tanı protokollerine ihtiyaç olduğu görülmektedir.

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