Sonographic appearances of cervical lymph nodes: Variations by age and sex

Ying, Michael; Ahuja, Anil T.; Brook, Fiona

doi:10.1002/jcu.10022

Cited by 55 publications

(29 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The specificity of the round shape is in fact linked to the long axis (6,8). Similarly, the absence of fatty hilum is often seen in normal individuals, especially in young subjects and LNs located in level V (19). Interestingly, we found a sensitivity of 100%, indicating that the persistence of a fatty hilum is a major criteria that excludes malignancy.…”

Section: Discussionmentioning

confidence: 53%

Ultrasound Criteria of Malignancy for Cervical Lymph Nodes in Patients Followed Up for Differentiated Thyroid Cancer

Leboulleux

Girard

Rosé

et al. 2007

The Journal of Clinical Endocrinology &Amp; Metabolism

452

300

View full text Add to dashboard Cite

Context: Neck ultrasonography (US) has become a keystone in the follow-up of patients with differentiated thyroid cancer.Objective: The aim of this study was to determine specificity and sensitivity of ultrasound criteria of malignancy for cervical lymph nodes (LNs) in patients with differentiated thyroid cancer. Design:We prospectively studied 19 patients referred to the Institut Gustave Roussy for neck LN dissection. All patients underwent a neck US within 4 d prior to surgery. Only LNs that were unequivocally matched between US and pathology were taken into account for the analysis. Results:One hundred three LNs were detected on US, 578 LNs were surgically removed, and 56 LNs were analyzed (28 benign and 28 malignant). Sensitivity and specificity were 68 and 75% for the long axis (Ն1 cm), 61 and 96% for the short axis (Ͼ5 mm), 46 and 64% for the round shape (long to short axis ratio Ͻ 2), 100 and 29% for the loss of fatty hyperechoic hilum, 39 and 18% for hypoechogenicity, 11 and 100% for cystic appearance, 46 and 100% for hyperechoic punctuations, and 86 and 82% for peripheral vascularization. Conclusion:Cystic appearance, hyperechoic punctuations, loss of hilum, and peripheral vascularization can be considered as major ultrasound criteria of LN malignancy. LNs with cystic appearance or hyperechoic punctuations are highly suspicious of malignancy. LNs with a hyperechoic hilum should be considered as benign. Peripheral vascularization has the best sensitivity-specificity compromise. Round shape, hypoechogenicity, and the loss of hilum taken as single criteria are not specific enough to suspect malignancy. N ECK ULTRASONOGRAPHY (US) has replaced radioactive iodine in the follow-up of patients with differentiated thyroid cancer (DTC) (1, 2). Sensitivity of US for the diagnosis of neck recurrence ranges from 70 to 100% (3-5). Metastatic lymph nodes (LNs) tend to be large, round, hypoechoic, and hypervascularized with a loss of hilar architecture (6 -13). In DTC, metastatic LNs may also demonstrate specific features such as hyperechoic punctuations or microcalcifications and cystic appearance (14 -16). The specificity of these US criteria in DTC is, however, not well known and difficult to assess on follow-up only because of the indolent nature of DTC. Specificity of US criteria based on pathology are, in fact, not available in DTC. Confirmation of malignancy of suspicious LN found on US is usually recommended and consists in a fine-needle aspiration biopsy (FNAB) for cytology and thyroglobulin determination in the aspirate fluid (17). There is a need for specific criteria of malignancy; otherwise, a majority of DTC patients will be submitted to FNAB, a stressful examination with potential morbidity.We therefore assessed both sensitivity and specificity of US criteria based on pathology in patients planned to neck LN dissection for DTC neck recurrence. Patients and Methods PatientsPatients referred to the Institut Gustave Roussy from February 2004 to January 2005 for surgical treatment of a neck recurrence of DTC...

show abstract

Section: Discussionmentioning

confidence: 53%

Ultrasound Criteria of Malignancy for Cervical Lymph Nodes in Patients Followed Up for Differentiated Thyroid Cancer

Leboulleux

Girard

Rosé

et al. 2007

The Journal of Clinical Endocrinology &Amp; Metabolism

452

300

View full text Add to dashboard Cite

show abstract

“…A criterion that is frequently utilized to define lymph node enlargement is the smallest diameter > 4 mm (measured by means of ultrasonography) or 5 mm (CT) (14)(15)(16)(17) . However, enlarged lymph nodes are found on imaging studies of asymptomatic patients, with these same values (14,(18)(19)(20) . Even so, the literature commonly reports that lymph nodes are rarely seen at CT of children in the usual age range for WT (21) .…”

Section: Discussionmentioning

confidence: 70%

Local behavior and lymph node metastases of Wilms' tumor: accuracy of computed tomography

Silva

2014

Radiol Bras

View full text Add to dashboard Cite

ResumoObjective: To evaluate the accuracy of computed tomography for local and lymph node staging of Wilms' tumor. Materials and Methods: Each case of Wilms' tumor was evaluated for the presence of abdominal lymph nodes by a radiologist. Signs of capsule and adjacent organ invasion were analyzed. Surgical and histopathological results were taken as the gold standard. Results: Sensitivity was 100% for both mesenteric and retroperitoneal lymph nodes detection, and specificity was, respectively, 12% and 33%, with positive predictive value of 8% and 11% and negative predictive value of 100%. Signs of capsular invasion presented sensitivity of 87%, specificity of 77%, positive predictive value of 63% and negative predictive value of 93%. Signs of adjacent organ invasion presented sensitivity of 100%, specificity of 78%, positive predictive value of 37% and negative predictive value of 100%. Conclusion: Computed tomography tumor showed low specificity and low positive predictive value in the detection of lymph node dissemination. The absence of detectable lymph nodes makes their presence unlikely, and likewise regarding the evaluation of local behavior of tumors.Keywords: Computed tomography; Wilms' tumor; Staging.Objetivo: Avaliar a acurácia da tomografia computadorizada no estadiamento local e linfonodal de pacientes com tumor de Wilms. Materiais e Métodos: Um radiologista avaliou a presença de linfonodos abdominais em cada caso. Sinais de invasão capsular e de órgão adjacente foram analisados. Resultados cirúrgicos e histopatológicos foram tomados como padrão ouro. Resultados: A sensibilidade da detecção de linfonodos mesentéricos e retroperitoneais foi 100% (ambos) e a especificidade foi 12% e 33%, respectivamente, com valores preditivos positivos de 8% e 11% e negativos de 100% (ambos). Sinais de invasão capsular apresentaram sensibilidade de 87%, especificidade de 77% e valores preditivos positivo de 63% e negativo de 93%. Invasão de órgão adjacente foi diagnosticada com sensibilidade de 100%, especificidade de 78% e valores preditivos positivo de 37% e negativo de 100%. Conclusão: A tomografia computadorizada mostrou baixa especificidade e valor preditivo positivo na detecção de disseminação linfonodal. Ausência de linfonodos detectáveis tornou a disseminação improvável, assim como sinais de invasão local.

show abstract

“…Malignant lymph nodes usually do not show echogenic hilus. However, it has been reported that echogenic hilus may also be found in malignant lymph nodes and small normal nodes [6,8]. Therefore, the presence or absence of echogenic hilus should not be used as a sole criterion for evaluating cervicofacial lymphadenopathy.…”

Section: Resultsmentioning

confidence: 99%

Characterization of Cervicofacial Lymphnodes - A Clinical and Ultrasonographic Study

Mufeed³

et al. 2014

JCDR

View full text Add to dashboard Cite

Background: Lymph nodes undergo reactive changes in response to a wide variety of stimuli, the most common cause being inflammatory and immune reactions, apart from primary malignant neoplasms and metastatic tumours. It is well accepted that a clinical examination alone cannot be considered diagnostic to justify the involvement of cervicofacial lymph nodes especially deep and small nodes. Ultrasonography is an easy, reproducible, non invasive, non-ionizing imaging modality to evaluate cervicofacial lymph nodes. Aim:The present study was devised with an aim of comparing the clinical and ultrasonographic features of cervicofacial lymphadenopathy. Materials and Methods:The subjects for the study were selected from the patients who visited the outpatient department with clinically palpable lymph nodes. Fifty two patients were included in the study and they were divided into 4 groups; group I (subjects with odontogenic infections), group II (subjects with non odontogenic oral conditions), group III (subjects with tuberculosis) and group IV (subjects with head and neck carcinomas). A detailed case history was recorded and a thorough clinical examination was carried out for all subjects. The cervicofacial lymph nodes were palpated and examined. Ultrasonographic examination of cervicofacial lymph nodes was carried out and recorded. The statistical analysis was done using chi square test. Result and Conclusion:Most of the subjects considered for the study showed cervicofacial lymphadenopathy associated with odontogenic causes, specific infections like tuberculosis and head and neck malignancies. The lymph nodes showed varied clinical features. The ultrasonographic features such as number, size, shape, short axis/long axis ratio, border sharpness, hilum, echogenicity, distribution of the internal echoes, intranodal necrosis, matting or soft tissue edema were evaluated. The results were tabulated and statistical analysis was done.

show abstract

Sonographic appearances of cervical lymph nodes: Variations by age and sex

Cited by 55 publications

References 26 publications

Ultrasound Criteria of Malignancy for Cervical Lymph Nodes in Patients Followed Up for Differentiated Thyroid Cancer

Ultrasound Criteria of Malignancy for Cervical Lymph Nodes in Patients Followed Up for Differentiated Thyroid Cancer

Local behavior and lymph node metastases of Wilms' tumor: accuracy of computed tomography

Characterization of Cervicofacial Lymphnodes - A Clinical and Ultrasonographic Study

Contact Info

Product

Resources

About