Current status of power Doppler and color Doppler sonography in the differential diagnosis of lymph node lesions

Hj, Steinkamp; Wissgott, Christian; Rademaker, J.; Félix, R.

doi:10.1007/s003300101111

Cited by 64 publications

(60 citation statements)

References 32 publications

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“…Uma das hipóteses para o deslocamento dos vasos hilares levantadas por Salwei et al (2005) e Steinkamp et al (2002) é a de que proliferação de células neoplásicas possa gerar um efeito de massa e alterar o curso normal dos vasos hilares, deslocando-os para a periferia; quanto aos vasos aberrantes, existe a possibilidade de representarem neovascularização resultante da angiogênese. Steinkamp et al (2002) relatam que o tipo de padrão vascular com aspecto pontilhado, periférico ou misto, depende do tempo de evolução do processo metastático, do grau de inϐil-tração celular e de angiogênese e da presença de áreas de necrose.…”

Section: Discussionunclassified

Avaliação ultrassonográfica de linfonodos na pesquisa de metástases de neoplasia mamária em cadelas

et al. 2011

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A avaliação de linfonodo, parte importante do estadiamento das neoplasias mamárias em cadelas, pode auxiliar no estabelecimento do prognóstico e na escolha da conduta terapêutica. A ultrassonografia em modo B possibilita avaliação de tamanho, contorno, borda, forma, arquitetura, ecotextura e ecogenicidade do parênquima dos linfonodos e, em modo Doppler, da quantidade e distribuição dos seus vasos internos. Este trabalho visou identificar as características ultrassonográficas mais importantes utilizadas para classificar os linfonodos em metastáticos e não-metastáticos, estabelecer elementos de confiabilidade do ultrassom como ferramenta para diferenciar linfonodos metastáticos de não-metastáticos e estabelecer procedimentos de reprodução deste exame. Foram examinados 67 linfonodos inguinais superficiais de 30 cadelas com tumor mamário e cada linfonodo foi classificado como metastático ou não-metastático. A impressão diagnóstica ultrassonográfica foi associada aos resultados do exame histopato lógico dos linfonodos obtendo-se taxa de concordância de 92,5%, índice de sensibilidade de 94,1%, índice de especificidade de 92%, valor preditivo positivo de 0,8 e valor preditivo negativo de 0,9787. Características ultrassonográficas que classificaram um linfonodo como metastático ou como não-metastático foram listadas. O exame ultrassonográfico dos linfonodos regionais constitui importante ferramenta na detecção de metástase e sugere-se incluí-lo como rotina do estadiamento de neoplasias mamárias em cadelas.

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Section: Discussionunclassified

Avaliação ultrassonográfica de linfonodos na pesquisa de metástases de neoplasia mamária em cadelas

et al. 2011

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“…Technologies used to select patients for invasive investigation have been described. [26][27][28][29] However, it is unlikely that the selection of patients for biopsy will be successfully optimised without more formal guidance for lymphadenopathy assessment, whether or not that assessment is carried out within a single multidisciplinary clinic. Mechanisms for reducing the time to biopsy can then be employed to better effect.…”

Section: Discussionmentioning

confidence: 99%

Waiting Time to Lymph Node Biopsy is Dependent on Referral Method: Don't Write, Phone!

Pannick

Clark

2009

annals

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INTRODUCTION Patients with lymphadenopathy are commonly referred to general surgeons for diagnostic lymph node biopsy. We were concerned at potential long waits for this service in our hospital and thus wanted to compare the efficiency of written and telephone referral with a view to identifying the optimum care pathway for these patients. PATIENTS AND METHODS Sixty patients were included in a 2-year retrospective review (excluding referrals associated with breast lumps which were managed separately). Hospital Episode Statistics data were used to analyse notes for the source and method of referral, waiting time to biopsy, clinic attendance and diagnosis. RESULTS Of referrals, 33% were from haematology and 28% from general practice. Overall, 47% of patients were referred by letter; of these, 64% were seen in clinic before biopsy. Personal referral between clinicians, by direct discussion, e-mail or fax led to a mean wait of 4 days, compared to 51 days when patients were referred by letter. Clinic attendance had no significant bearing on diagnostic accuracy or complication rate. Neoplasia accounted for 43% of diagnoses and infection (including four cases of tuberculosis) for 10%. Of biopsies, 33% showed benign changes, 8% were unrecorded and 5% were incorrect. CONCLUSIONS In this study, 43% of biopsies revealed malignancy and we advise that lymph node biopsy requests should be managed on a fast-track pathway, expedited by direct personal request. Following this study, we have implemented a fast-track pathway for such patients. PANNICK INGHAM CLARK WAITING TIME TO LYMPH NODE BIOPSY IS DEPENDENT ON

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“…Further, neoplastic tumor cells can secrete various kinds of angiogenic factors that simulate growth and formation of de novo vessels. These vessels differ from preexisting vessels and produce abnormal hemodynamics features, such as arterial-venous shunts due to lack of a muscular layer (8). In addition, neoplastic tissue may compress and even encase a vessel, increasing pressure in the parenchyma and decreasing the blood flow.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of supplementary diagnostic value of contrast-enhanced ultrasound for lymph node puncture biopsy

et al. 2017

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Background: Contrast enhanced ultrasound (CEUS) is an effective way to evaluate the distribution of micro vessels in organs with little invasiveness. The qualitative evaluation and differential diagnosis of lymph node is essential for a number of clinical situations, including appropriate examination selection, oncologic staging, therapy and prognosis beyond diagnosis itself. The purpose of this study is to investigate the contribution of characterization of cervical lymphadenopathies on CEUS as an indication for lymph node puncture biopsy.Methods: Records of 157 lymph nodes from 103 patients who had undergone CEUS examination were studied retrospectively, and enhancement patterns and characteristics were evaluated. The diagnoses obtained by means of core-needle biopsy examination or surgical removal, or patients were closely followed-up for at least 6 months. Of the lymph nodes examined, 94 were benign (48 lymphadenitis and 46 tuberculosis) and 63 were malignant (55 metastases and 8 lymphomas). The vascular characterization of lymph nodes was compared with results obtained by pathologic examination. Results:The study using CEUS showed 55 (54.5%) cases of "peripheral" enhancement in group A and 47 (83.9%) cases of "hilar normal or activated" in group B. Inhomogeneous "spotted or cycle-like" enhancement in the equilibrium phase was seen in 80 (79.2%) cases of group A and only 11 (19.6%) cases of group B. The specificity, sensitivity and accuracy of CEUS examination result as an indication for puncture biopsy were 80.4%, 81.2% and 80.9%, respectively.Conclusions: Centripetal perfusion in the early arterial phase or inhomogeneous spotted or cycle-like enhancement in the equilibrium phase of the cervical lymph nodes during CEUS can be used as an indication for core-needle biopsy with a high degree of accuracy. Conversely, for lymph nodes with more variable appearances, surgical removal or closely followed-up of nodes may be more appropriate.

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Current status of power Doppler and color Doppler sonography in the differential diagnosis of lymph node lesions

Cited by 64 publications

References 32 publications

Avaliação ultrassonográfica de linfonodos na pesquisa de metástases de neoplasia mamária em cadelas

Avaliação ultrassonográfica de linfonodos na pesquisa de metástases de neoplasia mamária em cadelas

Waiting Time to Lymph Node Biopsy is Dependent on Referral Method: Don't Write, Phone!

Evaluation of supplementary diagnostic value of contrast-enhanced ultrasound for lymph node puncture biopsy

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