From the Guidelines
Intraparotid lymph nodes are lymph nodes located within the parotid gland that are at risk of metastases in high-grade or advanced-stage parotid cancer.
Key Points
- Intraparotid lymph nodes are relevant in the context of parotid cancer, particularly in high-grade or advanced-stage cases 1.
- The risk of intraparotid nodal metastases is a consideration in the surgical management of parotid cancer, with recommendations for at least a superficial parotidectomy 1.
- The presence of intraparotid lymph nodes and the risk of metastases inform the decision to perform a total or subtotal parotidectomy, balancing the need for tumor removal with the risk to the facial nerve 1.
- The management of intraparotid lymph nodes is part of a broader approach to parotid cancer treatment, which may include adjuvant radiation therapy (RT) to reduce the risk of recurrence 1.
From the Research
Definition and Location of Intraparotid Lymph Nodes
- Intraparotid lymph nodes are lymph nodes located within the parotid gland, which is a salivary gland situated on either side of the face, in front of and below the ears 2.
- These lymph nodes are distributed throughout the parotid gland, with the largest number (47%) found in the lower half of the superficial lobe, and 35% concentrated in the inferior part of the cervicofacial branch, i.e., the lower pole of the parotid gland 2.
Clinical Significance of Intraparotid Lymph Nodes
- Intraparotid lymph nodes can be involved in metastases from primary parotid carcinomas and other head and neck carcinomas, and their presence or absence can impact treatment outcomes 2, 3.
- The detection of metastases in intraparotid lymph nodes during surgery may require selective neck dissection (at least levels II and III) to be performed simultaneously 2.
- Intraparotid lymph nodes can also be affected by various lymphoid processes, including reactive hyperplasia and malignant lymphoma, which can be diagnosed using fine-needle aspiration cytology (FNA) 4, 5, 6.
Diagnosis of Intraparotid Lymph Nodes
- Fine-needle aspiration cytology (FNA) is a useful procedure for diagnosing intraparotid lymph nodes, allowing for the identification of reactive processes, lymphomas, and other conditions 4, 5, 6.
- Imaging studies, such as ultrasound, CT, and PET/CT, can also be used to evaluate intraparotid lymph nodes, but may not always be able to distinguish between metastases and primary parotid tumors 3.
- In some cases, intraoperative frozen section biopsy may be performed to identify intraparotid lymph nodes during surgery 2.