http://www.ncbi.nlm.nih.gov/pubmed/24923670

http://www.ncbi.nlm.nih.gov/pubmed/23751849

Jas, the evidence with FNA is that cytology is pretty good.  Some new EUS FNA needles can however also give a histological sample.

Thanks Nev!

Also for head and neck carcinoma metastases:

http://www.ncbi.nlm.nih.gov/pubmed/24890924

http://www.ncbi.nlm.nih.gov/pubmed/22967965

http://www.ncbi.nlm.nih.gov/pubmed/16361135

http://www.ncbi.nlm.nih.gov/pubmed/11152817

Radiology. 1991 Aug;180(2):457-61.

Occult metastatic neck disease: detection with US and US-guided fine-needle aspiration cytology.

van den Brekel MW1, Castelijns JA, Stel HV, Luth WJ, Valk J, van der Waal I, Snow GB.

Author information

• 1Department of Otorhinolaryngology and Head and Neck Surgery, Free University Hospital, Amsterdam, The Netherlands.

Erratum in

• Radiology 1992 Jan;182(1):288.

Abstract

The authors performed a prospective study of the value of ultrasonography (US) and US-guided fine-needle aspiration cytology (FNAC) for assessment of N0 lesions in the neck. Preoperative US was performed in 107 patients with squamous cell carcinoma of the head and neck, who underwent 132 elective neck dissections. During the US examination of the last 54 patients, who underwent 70 elective neck dissections, US-guided FNAC was performed. US alone was found to be an unreliable method for detecting occult lymph node metastasis; the accuracy never exceeded 70% (93 of 132), with a sensitivity of 60% (32 of 53) and a specificity of 77% (61 of 79). In contrast, US-guided FNAC had an accuracy of 89% (62 of 70), a sensitivity of 76% (25 of 33), and a specificity of 100% (37 of 37). Because of the high sensitivity and specificity of US-guided FNAC for the assessment of the N0 neck, this modality may play an important role in directing treatment of these patients in the future.