scholarly journals Evaluation of Ultrasonography and Colour Doppler in Cervical Lymphadenopathy Taking Histopathology as Comparison

2021 ◽  
Vol 10 (19) ◽  
pp. 1391-1397
Author(s):  
Prinson George ◽  
Aria Jyothi Appukuttan
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Imaging Modality ◽  
Cervical Lymphadenopathy ◽  
Colour Doppler ◽  
Likelihood Ratios ◽  
Cervical Lymph Nodes ◽  
Grey Scale

BACKGROUND Grey scale ultrasonography can be used as a first line imaging modality along with histopathology for evaluation of cervical lymphadenopathy. Morphologic features like size, shape, hilum and necrosis within the lymph node and vascularity are analysed. We wanted to identify the role of Grey scale ultrasonography and colour Doppler in characterisation of enlarged cervical lymph nodes, evaluate findings in benign and malignant cervical lymphadenopathy and assess the sensitivity, specificity, predictive value, likelihood ratios and accuracy in malignant and benign cervical lymph node enlargement. METHODS This was a cross sectional study with diagnostic test evaluation. All suspected cases of cervical lymphadenopathy referred for sonological evaluation to the Department of Radiodiagnosis of Govt. T.D. Medical College, Alappuzha were included in the study. About 75 patients included in the study, underwent Grey scale and colour Doppler sonography of cervical lymphadenopathy. RESULTS When three criteria were positive for malignancy, the sensitivity and specificity of grey scale ultrasonography and colour Doppler were 100 % and 73.80 %, and when four criteria were positive, the sensitivity and specificity were 72.73 %, and 90.48 % respectively. When we analysed individual variables, status of hilum (absence / presence) has reasonably good sensitivity and specificity, positive predictive value, negative predictive value and accuracy (90.09 %, 92.90 %, 90.09 %, 92.90 % and 92.0 % respectively). In our study the important criteria positive for malignant lymph nodes were size > / 11 mm in short axis diameter, round shape, absent hilum and peripheral and central + peripheral type of vascularity of cervical lymph nodes. For benign lymph nodes, oval shape, presence of hilum and central vascularity were the important criteria noted. CONCLUSIONS Grey scale ultrasonography can be complemented by colour Doppler ultrasonography (USG) in patients presenting with cervical lymphadenopathy to differentiate between benign and malignant lesions by reducing unnecessary biopsies by more accurate discrimination. KEY WORDS Grey Scale Ultrasonography, Malignant, Benign Lymph Nodes, Histopathology

Role of Clinical Palpation in Evaluation of Cervical Lymph Node in Oral Squamous Cell Carcinoma

2013 ◽  
Vol 1 (2) ◽  
pp. 02-06
Author(s):  
SM Anwar Sadat ◽  
Sufia Nasrin Rita ◽  
Shoma Banik ◽  
Md Nazmul Hasan Khandker ◽  
Md Mahfuz Hossain ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Oral Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Predictive Value ◽  
Cervical Lymph Node ◽  
Betel Quid ◽  
Cervical Lymph Nodes

A cross sectional study of 29 cases of oral squamous cell carcinoma with or without  cervical lymph node metastasis was done among Bangladeshi patients from January 2006 to December 2007. Majority of the study subjects (34.5%) belonged to the age group of 40-49 years. 58.6% of the study subjects were male, while remaining 41.4% of them were female. 51.7% of the lesions were located in the alveolar ridge where the other common sites were buccal mucosa (27.6%) and retro molar area (13.8%). Half of the study subjects (51.7%) were habituated to betel quid chewing followed by 37.9% and 10.3% were habituated to smoking and betel quid-smoking respectively. Grade I lesions was most prevalent (75.9%) in the study subjects.  Majority of cases presented with Stage IV lesions (55.2%). The sensitivity, specificity, positive predictive value, negative predictive value & accuracy of clinical palpation method for determining metastatic cervical lymph nodes were 93.33%, 64.29%, 73.68%, 90% and 79.3% respectively. Careful and repeated clinical palpation plays important role in evaluation of cervical lymph nodes though several modern techniques may help additionally in the management of oral cancer.DOI: http://dx.doi.org/10.3329/updcj.v1i2.13978 Update Dent. Coll. j. 2011: 1(2): 02-06

scholarly journals Histomorphological Pattern of Cervical Lymphadenopathy

2013 ◽  
Vol 3 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Md Atiqur Rahman ◽  
Md Mamun Ali Biswas ◽  
Syeda Tasfia Siddika ◽  
Abdul Mannan Sikder
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Hodgkin Lymphoma ◽  
Cervical Lymphadenopathy ◽  
Histological Evaluation ◽  
Cervical Lymph Nodes ◽  
Female Ratio ◽  
Study Results ◽  
Metastatic Neoplasm ◽  
Age And Sex

Background: Enlarged palpable cervical lymph nodes as a primary presenting sign are very common and may be due to inflammatory lesions and tumors. Correlation between clinical findings and laboratory data is essential in arriving at a diagnosis. In patients presenting with cervical lymphadenopathy, excision biopsy provides material to establish an early diagnosis. We designed this study in our population for histological evaluation of cervical lymph node biopsies that might be important in the management of these patients. Objective: Histopathological evaluation of different diseases involving the cervical lymph nodes in relation to age and sex of the study population. Materials and Methods: It was a cross sectional study conducted in the department of Pathology, Enam Medical College & Hospital, Savar, Dhaka during the period from January 2006 to December 2010. A total of 107 patients were evaluated for specific cause of cervical lymphadenopathy in relation to age and sex. Lymph node biopsies of all patients of both sexes and all age groups were included in the study. Results: Among the 107 subjects 58 (54.2%) were males and 49 (45.8%) were females with a male to female ratio of 1.2:1. The age of the patients ranged from 2 to 85 years with a mean age of 32.68 ± 18.01 years. Of the 107 lymph node biopsies, 34 cases (31.8%) were reactive lymphadenitis, 41 cases (38.3%) were tuberculosis, 2 cases (1.9%) were non-caseous granuloma, 6 cases (5.6%) were Hodgkin lymphoma, 8 cases (7.5%) were non-Hodgkin lymphoma, 12 cases (11.2%) were metastatic neoplasm and 4 cases (3.7%) were other specific lesions. Conclusion: The commonest cause of cervical lymphadenopathy was tuberculosis, followed by reactive lymphadenitis, lymphoma and metastatic neoplasm. DOI: http://dx.doi.org/10.3329/jemc.v3i1.13837 J Enam Med Col 2013; 3(1): 13-17

scholarly journals A Hospital Based Observational Study on Diagnostic Role of High-Resolution Ultrasound and Doppler Imaging in Evaluation of Non-Thyroidal Neck Masses of Patients Attending the Department of Radiodiagnosis, AMCH, Dibrugarh with FineNeedle Aspiration / Histopathological Correlation

2021 ◽  
Vol 8 (11) ◽  
pp. 597-602
Author(s):  
Kallol Prasad Das ◽  
Pronami Borah ◽  
Mondita Borgohain ◽  
Rudra Kanta Gogoi ◽  
Raamseena N.A.
Keyword(s):  
Lymph Node ◽  
High Resolution ◽  
Lymph Nodes ◽  
Adult Population ◽  
Cervical Lymphadenopathy ◽  
Doppler Imaging ◽  
Neck Swelling ◽  
Colour Doppler ◽  
Female Ratio ◽  
Study Results

BACKGROUND Neck swellings consists of a wide spectrum of pathological entities. These swelling can occur due to a variety of aetiologies consisting of congenital, acquired inflammatory, neoplastic, or vascular origin. It is essential to have an extensive knowledge of the anatomy and contents of each cervical compartment to achieve a diagnosis. The age of presentation and clinical findings often narrows down the differential diagnosis. Ultrasonography (USG) is helpful in differentiating the nature of the lesions and differentiating solid from cystic neck lesions. Ultrasound is often used as an initial modality for pre-treatment assessment of any neck swelling. METHODS Patients with clinically palpable / non-palpable neck swellings were scanned using 7.5 - 11 MHz transducers, excluding patients with diagnosed thyroid swellings. RESULTS In total 120 cases were studied; the mean age of patients was 34 years with a male to female ratio of 1.1:1. The age wise categorisation included paediatric population (34.2 %) and adult population (65.8 %). 96 (80 %) cases presented with painless neck swelling, 76 (63.3 %) cases were non-neoplastic and 44 (36.7 %) cases were neoplastic in nature. Cervical lymphadenopathy being the most common ultrasound finding in both paediatric and adult population. Malignant lesions were most common in adult age group. Heterogeneous echotexture, rounded nodes, intranodal necrosis, loss of echogenic hila, peripheral nodal blood flow and increased pulsatility index (PI) and resistive index (RI) were important features of malignant lymph nodes. Sensitivity and specificity of USG and Doppler in differentiating neoplastic from non-neoplastic lesions were 97.7 % and 98.3 % respectively and for differentiating benign from metastatic nodes were 97.7 % and 98.3 % respectively. CONCLUSIONS Considering the study results and observations, USG is the best initial investigation for the evaluation of inflammatory, cystic and neoplastic swellings in various age groups. It is non-invasive, cost effective readily available and repeatable technique. It is relatively easier to use and does not involve radiation hazards. Colour Doppler can evaluate the vascularity of the lesions and provide details of any vascular invasion of metastatic lesions. Ultrasound can differentiate aetiology of lymph node enlargement to a significant extent. KEYWORDS High Resolution Ultrasound, Paediatric Neck Mass, Metastatic Lymph Node, Histopathology, FNAC, Tubercular Lymph Nodes, Colour Doppler, Non-Thyroidal

Reactive Lymphoid Hyperplasia or Tubercular Lymphadenitis: Can Real-Time PCR on Fine-Needle Aspirates Help Physicians in Concluding the Diagnosis?

2018 ◽  
Vol 62 (3) ◽  
pp. 204-208 ◽  
Author(s):  
Vivek Gupta ◽  
Arvind Bhake
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Real Time ◽  
Predictive Value ◽  
Lymphoid Hyperplasia ◽  
Reactive Lymphoid Hyperplasia ◽  
Rt Pcr ◽  
Likelihood Ratios ◽  
Diagnostic Challenge ◽  
Cross Sectional

Background: Enlarged lymph nodes in adult patients often present a diagnostic challenge. In the absence of granuloma or necrosis, the cytology/tissue findings are misleading and relate the enlarged lymph nodes to reactive lymphoid hyperplasia (RLH), because granuloma formation is an immunological response that usually takes 14–100 days to develop. This study assesses the role of real-time (RT)-PCR in the diagnosis of the Mycobacterium complex (MTBC) in lymph node aspirates compared with culture in cases of RLH. Methods: A cross-sectional study was conducted on 112 patients, aged 15–74 years, with a diagnosis of RLH on cytology. RT-PCR for MTBC detection and culture on Löwenstein-Jensen medium for tubercular bacilli was done on lymph node aspirates. Comparative values with reference to culture were calculated. The χ2 value, positive predictive value (PPV), negative predictive value (NPV), and likelihood ratios (LR) were calculated. Results: Out of 112 RLH cases, 35 (31%) were positive on both RT-PCR and culture. RT-PCR was positive in 43 cases and culture was positive in 44 cases. The χ2 test was found to be highly significant. PPV, NPV, positive LR, and negative LR were 81.4%, 87%, 6.76, and 0.23, respectively. Conclusion: RT-PCR for MTBC proves to be useful in arriving at a conclusive diagnosis in patients with a cytological diagnosis of RLH.

scholarly journals Ultrasound diagnosis of cervical levels II–IV lymph node metastasis in patients with first diagnosed papillary thyroid cancer

2020 ◽  
Vol 9 (4) ◽  
pp. 17-23
Author(s):  
V. S. Parshin ◽  
A. A. Veselova ◽  
V. S. Medvedev ◽  
S. A. Ivanov ◽  
A. D. Kaprin
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Predictive Value ◽  
Imaging Method ◽  
Thyroid Tumors ◽  
Papillary Thyroid ◽  
Cervical Lymph Nodes ◽  
Study Objective

The study objective is to explore the potentialities of ultrasound in the detection of metastasis from papillary thyroid cancer (PTC) to cervical lymph nodes in levels II–IV.Materials and methods. In 97 patients with first diagnosed PTC, surgical removal of the cervical lymph node-bearing fat at levels II–IV was performed. All patients underwent preoperative neck ultrasound. The results were verified by histology.Results. Cervical levels II–IV lymph node metastases were revealed in 82 (84,5 %) cases by sonography and in 86 (88,6 %) cases by histology. Ultrasound showed a sensitivity of 93 %, specificity of 81 %, accuracy of 91 %, positive predictive value of 97 % and negative predictive value of 60 %. Of 1620 removed lymph nodes, 443 (27,3 %) showed metastases confirmed by histology. Sonography revealed 422 (26,0 %) metastatic lymph nodes. Metastasis from intra-thyroid tumors was noted in 94,1 % and from extra-thyroid tumors in 87,5 % of patients. Metastasis from solitary tumors occurred in 86,5 % and from multicentric tumors in 92,1 % of cases. Multiple metastases made up 89,5 % and solitary metastases – 10,5 %.Conclusion. Sonography is a highly informative diagnostic imaging method in detecting metastasis from PTC to levels II–IV cervical lymph nodes and can be used for basic assessment of thyroid abnormalities.

scholarly journals The Use of Neck Sonography in Identifying Cervical Lymph Node: A Single Center Study from 2019 to 2020

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Azim Motamedfar ◽  
Mohammad Momen Gharibvand ◽  
Mojgan Sametzade ◽  
Mahsa Akhavan Sabagh
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Cervical Lymphadenopathy ◽  
Primary Source ◽  
Needle Aspiration ◽  
Tnm Staging ◽  
Lymph Node Biopsy ◽  
Cervical Lymph Nodes ◽  
Primary Tumors ◽  
Neck Lymph Node

Background: Tumor metastasis, as one of the most important prognostic factors in solid tumors, affects survival remarkably. Cervical lymphadenopathy (LAP) reflects an advanced-stage disease and changes the tumor-node-metastasis (TNM) staging of tumor, resulting in a multidisciplinary approach to the management of cancer. Objectives: This study aimed to assess the importance of neck sonography in monitoring primary tumors. Methods: Records of 166 patients with distant primary cancers who underwent neck sonography from February 2019 to February 2020 were studied. Abnormal lymph nodes were reported, and then the patients underwent neck sonography and fine needle aspiration (FNA) or core needle biopsy (CNB) under direct US guidance. Thirty-two patients who were confirmed for malignant cervical LAP underwent neck lymph node biopsy as an easy and safe way to provide tissue diagnosis instead of providing biopsy from the primary source of tumor. Results: Malignant cervical LAP was confirmed in 32 patients (19.2%) by neck sonography. Seventy-seven patients (46.4%) were male and 89 patients (53.6%) were female. The patients were 22 to 88 years old (mean age = 57.7 years; standard deviation = 12.7). Thirty-two patients (19.2%) had pathological cervical lymph nodes and 134 patients (80.8%) did not have. Conclusions: Metastatic cervical LAP found by neck ultrasound will change pretreatment TNM staging of disease to provide optimal treatment on a case-by-case basis. According to the result of this study, routine neck sonography in patients with distant primary tumors is recommended.

Congenital Thyroid Teratoma: A Case with Persistent Neuroglial Involvement of Cervical Lymph Nodes

1998 ◽  
Vol 1 (4) ◽  
pp. 322-327 ◽  
Author(s):  
C.E. Keen ◽  
A.J. Said ◽  
M. Agrawal ◽  
P.J. Berry
Keyword(s):  
Lymph Node ◽  
Glial Fibrillary Acidic Protein ◽  
Lymph Nodes ◽  
Thyroid Tissue ◽  
Cystic Teratoma ◽  
Cervical Lymphadenopathy ◽  
Cervical Lymph Nodes ◽  
Primary Surgery ◽  
Thyroid Mass ◽  
Nodal Spread

A case of congenital thyroid teratoma with nodal spread is reported. Primary surgery was performed on a female infant on the 6th day of life. The thyroid mass was removed in toto, and an adjacent 1.2 cm lymph node was also removed. Histology showed solid and cystic teratoma with a variety of elements including prominent neuroglial tissue that was neuroblastoma-like in places. Residual compressed non-neoplastic thyroid tissue was identified in the subcapsular plane. The lymph node was largely replaced by neuroglial tissue that was cellular in some areas and showed intrasinusoidal growth and some mitotic activity. Recurrent cervical lymphadenopathy gradually developed, commencing a few months after surgery. Excision of cervical nodes was undertaken at 9 months of age. About 13 nodes up to 2 cm in diameter were excised. Most of the specimens consisted of reactive lymph nodes, but in three of the smaller nodes, there were subcapsular and sinusoidal masses of focally cellular neuroglial tissue, again with occasional mitoses. This tissue stained strongly for glial fibrillary acidic protein, in addition to expressing neural markers. The lymph node “deposits” were interpreted as “displaced” lesional tissue rather than metastases in the usual, aggressive sense. The girl remains well at 5 years of age.

scholarly journals Frequency of Infection in Cervical Lymph Node Biopsy Site using Chlorhexidine and Povidine Iodine

2018 ◽  
Vol 2 (1) ◽  
pp. 24-30
Author(s):  
Qudrat Ullah ◽  
Anam Parvaiz ◽  
Usman Ali Rehman ◽  
Asif Hanif ◽  
Sami Ullah Bhatti
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Cervical Lymphadenopathy ◽  
Lymph Node Biopsy ◽  
Skin Preparation ◽  
Cervical Lymph Nodes ◽  
Node Biopsy ◽  
Cervical Lymph Node Biopsy ◽  
Povidine Iodine

Abstract:Background: Lymph node are located throughout the lymphatic system, they are concentrated in certain areas of the body including head and neck. Cervical lymph nodes are lymph nodes found in the neck. Of the 800 lymph nodes in the human body, 300 are in the neck. Cervical lymph nodes are subject to several different pathological conditions including tumours, infection and inflammation.Methodology: The Povidine-iodine and chlorhexidine for preoperative skin preparation in cervical lymph node biopsy procedure were used in this study and patients were asked for follow up after a week. On follow up day their wounds were checked, assessed and withdraw all stiches and complications were recorded accordingly and analysed them. It was discussed and showed that which one of Povidine-iodine and chlorhexidine is best to use for preoperative skin preparation in cervical lymph node biopsy procedures to reduce surgical site infection and economical one.Results: Out of 150 patients, 46% (69) were males and 54% (81) were females that had cervical lymphadenopathy after skin preparation by chlorhexidine antiseptic solution showed frequency of infection in total of 150 patients 16.67% (25) were infected while the other 83.33%(125) were not infected. Out of 150 patients who were underwent cervical lymphadenopathy after using povidine iodine skin preparatory antiseptic solution, 42% (63) were males and 58% (87) were females and among those frequency of infection showed 44.67% (67) were infected while the others 55.33% (83) were not.Conclusion: Preoperative scrubbing of the patient’s skin with chlorhexidine–alcohol is better than scrubbing with povidone–iodine for preventing surgical-site infection after cervical lymph node biopsy.

A comparison of the efficiency of diagnostic ultrasound and magnetic resonance imaging of cervical lymph nodes in papillary thyroid carcinoma

2021 ◽  
pp. 1-12
Author(s):  
Muhammad Asad Iqbal ◽  
Xian Wang ◽  
Zhang Guoliang ◽  
Nida Fatima Moazzam ◽  
Ahmad Daniyal Shahid ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Papillary Thyroid Cancer ◽  
Predictive Value ◽  
Cervical Lymph Node ◽  
Papillary Thyroid ◽  
Resonance Imaging ◽  
Cervical Lymph Nodes ◽  
Node Metastases

OBJECTIVE: To compare and evaluate diagnostic capabilities of preoperative ultrasonography (US) and magnetic resonance imaging (MRI) in the cervical lymph nodes of patients with papillary thyroid cancer. METHODS: A retrospective dataset involving 156 patients who had undergone thyroidectomy and preoperative US and MRI was assembled. Among these, 69 had cervical lymph node metastasis and 87 did not. At least four radiologists unilaterally and spontaneously investigated the US and MRI attributes of the cervical lymph nodes. The efficiency of diagnostic imaging for cervical lymph nodes, including their true-positive rate or sensitivity, true-negative rate or specificity, positive predictive value, negative predictive value, and predictive accuracy were analysed and assessed. RESULTS: In the assessment of cervical lymph node metastases of papillary thyroid cancer, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of diagnostic US vs. MRI were 58.0% vs. 79.7%, 69.0% vs. 83.9%, 59.7% vs. 79.7%, 67.4% vs. 83.9%, and 64.1% vs. 82.1%, respectively. The accuracy consistency of the two imaging modalities was 83.5%. CONCLUSIONS: MRI is more effective than US in diagnosing and assessing cervical lymph node metastases of papillary thyroid cancer.

scholarly journals Cervical lymph node enlargement as the initial manifestation of rectal cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tong-Hui Xie ◽  
Peng Su ◽  
Jian-Guo Hong ◽  
Hui Zhang
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Clinical Manifestations ◽  
Initial Symptom ◽  
Cervical Lymph Nodes ◽  
Supraclavicular Lymph Nodes ◽  
Lymph Node Enlargement

Abstract Background Colorectal cancer is a very common malignant tumor worldwide. The clinical manifestations of advanced colorectal cancer include the changes in bowel habits, hematochezia, diarrhea, local abdominal pain and other symptoms. However, the colorectal cancer with an initial symptom of cervical lymph node enlargement is extremely rare. In this article, we report a case of rectal cancer presenting with cervical lymph nodes enlargement as the initial symptom. Case presentation A 57-year-old woman was admitted to our hospital for cervical lymph node enlargement which was accidentally detected during physical examination. Computed tomography scan revealed multiple enlarged lymph nodes in the neck. Cervical ultrasound showed normal thyroid gland and multiple left supraclavicular lymph nodes enlargement. The patient underwent lymph nodes biopsy and pathologic results showed metastatic adenocarcinoma. The subsequent lower gastrointestinal endoscopy revealed a mucosal bulge lesion located at rectus and biopsy revealed adenocarcinoma. The patient underwent rectal cancer resection. She is alive with no evidence of recurrence or new tumors 2 years after surgery. Conclusions Cervical lymph node metastasis is a rare metastatic way in colorectal cancer. This is the first case of rectal cancer presenting with cervical lymph nodes metastases as the initial symptom. Surgical resection combined with postoperative chemotherapy improved long-term prognosis of the patient. This rare metastatic way of rectal cancer should be paid attention for clinicians.

Sign in / Sign up

Export Citation Format

Share Document