cervical lymph node ---usg

 Common locations of metastatic, lymphomatous and tuberculous nodes in the neck
                                                                                                         Commonly involved nodal groups
Metastases from oropharynx, hypopharynx, larynx carcinomas -----Internal jugular chain
Metastases from oral cavity carcinomas ---------------------------------SubmandibularUpper cervical
Metastases from infraclavicular carcinomas-----------------      Supraclavicular fossa Posterior triangle
Metastases from nasopharyngeal carcinoma -------------------Upper cervical,Posterior triangle
Metastases from papillary carcinoma of the thyroid------------ Internal jugular chain
Non-Hodgkin’s lymphoma ------------------------------Submandibular,Upper cervical.Posterior triangle
Tuberculosis ------------------------------------------------------Supraclavicular fossa,Posterior triangle




. Classic US criteria used in differentiating benign vs. malignant lymph nodes.
Criterion Benign Malignant
B scan criteria                                                                      BENIGN -----MALIGNANT
Size               ------------------------------------------------------- small--------- large
shape----------------------------------------------------------------- oval---------- rounded
hilum -----------------------------------------------------------------present-------- absent
echogenicity --------------------------------------------------moderate or low ------marked hypoechoic
margins ---------------------------------------------------------sharp ----------------------irregular, blurred,
Structural changes---------------------------------------------------absent----------- present
– focal cortical nodules
– intranodal necrosis
– reticulation
– calcification
– matting

Soft tissue edema --------------------------------------------------may be present---------- absent
Doppler criteria
Flow--------------------------------------------------------- absent------------------ present
Vessel location ----------------------------------------------central ------------------peripheral
Vascular pedicles---------------------------------------- single -----------------------multiple
Vascular pattern--------------------------------------- regular------------------------ chaotic
Impedance values--------------------------------------------- low--------------------- high




BENIGN LYMPH NODE



benign lymph node



lymphoma





Malignant lymph node