Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-23T14:02:30.768Z Has data issue: false hasContentIssue false
  • English
  • Français

A practical approach to ultrasound of cervical lymph nodes

Published online by Cambridge University Press:  29 June 2007

A. Ahuja ,
M. Ying ,
W. King  and
C. Metreweli
A. Ahuja*
Affiliation:
Department of Diagnostic Radiology, Prince of Wales Hospital, Shatin, N.T., Hong Kong.
M. Ying
Affiliation:
Department of Diagnostic Radiology, Prince of Wales Hospital, Shatin, N.T., Hong Kong.
W. King
Affiliation:
Department of Organ Imaging and Surgery, Prince of Wales Hospital, Shatin, N.T., Hong Kong.
C. Metreweli
Affiliation:
Department of Diagnostic Radiology, Prince of Wales Hospital, Shatin, N.T., Hong Kong.
*
Address for correspondence: Dr Anil T. Ahuja, Dept of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Shatin, N.T., Hong Kong. Fax: (852) 636 0012
Get access Rights & Permissions [Opens in a new window]

Abstract

Although the role of high resolution ultrasound (US) in evaluating cervical nodes is well established, it is often combined with fine needle aspiration cytology (FNAC). As a result, US appearances that help in distinguishing the various causes of cervical adenopathy are often overlooked and not emphasized. The aim of this study is to re-emphasize to the sonologist the US clues that may help in differentiating the aetiology of abnormal cervical nodes.

We, therefore, present the spectrum of US appearances of lymph nodes. One hundred and forty patients (702 abnormal nodes) with known pathology were compared with 100 normal subjects (1211 nodes).

After identifying an abnormal node, US features that further help in distinguishing between the various pathologies are the distribution of lymphadenopathy, echogenicity, calcification, distal enhancement, intranodal cystic necrosis, matting and soft tissue oedema.

Keywords

UltrasonographyLymph nodes
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 3 , March 1997 , pp. 245 - 256
Copyright
Copyright © JLO (1984) Limited 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahuja, A., Chow, L., Mok, C. O., King, W., Metreweli, C. (1995a) Metastatic cervical lymph nodes in papillary carcinoma of the thyroid: ultrasound and histological correlation. Clinical Radiology 50: 229–231.CrossRefGoogle ScholarPubMed
Ahuja, A., Ying, M., Evans, R., King, W., Metreweli, C. (1995b) The application of ultrasound criteria for malignancy in differentiating tuberculous cervical adenitis from metastatic nasopharyngeal carcinoma. Clinical Radiology 50: 391–395.CrossRefGoogle ScholarPubMed
Bruneton, J. N., Normand, F. (1987) Cervical lymph nodes. In Ultrasonography of the Neck. (Bruneton, J. ed.) Springer-Verlag, Berlin, Heidelberg, pp 81–92.CrossRefGoogle Scholar
De Lellis, R. A. (1989) Endocrine system. In Robbins Pathologic Basis of Disease. (Cotran, R. S., Kumar, V., Robbins, S. L., eds.) 4th Edition. W. B. Saunders Co., Philadelphia, pp 1205–1276.Google Scholar
Gorman, B., Charboneau, J. W., James, M. E., Reading, C. C., Wold, L. E., Grant, C. S., Gharib, H., Hay, I. D. (1987) Medullary thyroid carcinoma: Role of high resolution US. Radiology 162: 147–150.CrossRefGoogle ScholarPubMed
Gupta, A. K., Nayar, M., Chandra, M. (1992) Critical appraisal of fine needle aspiration cytology in tuberculous lymphadenopathy. Acta Cytologica 36 (3): 391–394.Google Scholar
Hajek, P. C., Salomonowitz, E., Turk, R., Tscholakoff, D., Kumpan, W., Czembriek, H. (1986) Lymph nodes of the neck: Evaluation with US. Radiology 158: 739–742.CrossRefGoogle ScholarPubMed
Harnsberger, H. R. (1995) Handbook of Head and Neck Imaging. 2nd Edition. Mosby-Year Book, St Louis, pp 199–223.Google Scholar
Ishii, J. I., Fuji, E., Suzuki, H., Shinozuka, K., Kawase, N., Amagasa, T. (1992) Ultrasonic diagnosis of oral and neck malignant lymphoma. Bulletin. Tokyo Medical and Dental University 39: 63–69.Google Scholar
Kline, T. S. (1981) Lymph nodes and superficial masses. In Handbook of Fine Needle Aspiration Cytology. (Lotz, J. E., ed.) CV Mosby, St Louis, pp 23–64.Google Scholar
Lindberg, R. (1972) Distribution of cervical lymph node metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer 29: 1446–1449.3.0.CO;2-C>CrossRefGoogle ScholarPubMed
Muraki, A. S., Mancuso, A. A., Harnsberger, H. R. (1984) Metastatic cervical adenopathy from tumours of unknown primary: The role of CT. Radiology 152: 749–753.CrossRefGoogle ScholarPubMed
Pilotti, S., Di Palma, S., Alasio, L., Bartoli, C., Rilke, F. (1993) Diagnostic assessment of enlarged superficial lymph nodes by fine needle aspiration. Acta Cytologica 37 (6): 853–866.Google ScholarPubMed
Rubaltelli, L., Proto, E., Salmaso, R., Bortoletto, P., Candiani, F., Cagol, P. (1990) Sonography of abnormal lymph nodes in vitro: Correlation of sonographic and histologic findings. American Journal of Roentgenology 155: 1241–1244.CrossRefGoogle ScholarPubMed
Sakai, F., Kiyono, K., Sone, S., Kondo, Y., Oguchi, M., Watanabe, T., Sakai, Y., Imai, Y., Takeda, S., Yamamoto, K., Ota, H. (1988) Ultrasonic evaluation of cervical metastatic lymphadenopathy. Journal of Ultrasound Medicine 7: 305–310.CrossRefGoogle ScholarPubMed
Schwerk, W. B., Grun, R., Wahl, R. (1985) Ultrasound diagnosis of C-cell carcinoma of the thyroid. Cancer 55: 624–630.3.0.CO;2-T>CrossRefGoogle ScholarPubMed
Shozushima, M., Suzuki, M., Nakashima, T., Yanagisawa, Y., Sakamaki, K., Takeda, Y. (1990) Ultrasound diagnosis of lymph node metastasis in head and neck cancer. Dentomaxillofacial Radiology 19: 165–170.CrossRefGoogle ScholarPubMed
Solbiati, L., Cioffi, V., Ballarati, E. (1992) Ultrasonography of the neck. Radiologic Clinics of North America 30 (5): 941–954.Google ScholarPubMed
Som, P. M. (1987) Lymph nodes of the neck. Radiology 165: 593–600.CrossRefGoogle ScholarPubMed
Tohnosu, N., Onada, S., Isono, K. (1989) Ultrasonographic evaluation of cervical lymph node metastases in esophageal cancer with special reference between the short to long axis ratio (S/L) and the cancer content. Journal of Clinical Ultrasound 17: 101–106.CrossRefGoogle Scholar
van Overhagen, H., Lameris, J. S., Berger, M. Y., van der Voorde, F., Tilanus, H. W. (1991) Carcinoma of the esophagus and gastro-esophageal junction: Assessment with CT, US, and US-guided fine needle aspiration biopsy. Radiology 179: 155–158.CrossRefGoogle ScholarPubMed
Ying, M., Ahuja, A., Brook, F., Brown, B., Metreweli, C. (1996) The sonographic appearances and distribution of normal cervical lymph nodes in Chinese population. Journal of Ultrasound Medicine 15: 431–436.CrossRefGoogle ScholarPubMed