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2017 | 17 | 68 | 59–65
Article title

Mistakes in ultrasound diagnosis of superficial lymph nodes

Content
Title variants
PL
Pomyłki w diagnostyce ultrasonograficznej węzłów chłonnych położonych powierzchownie
Languages of publication
EN
Abstracts
EN
The article discusses basic mistakes that can occur during ultrasound imaging of superficial lymph nodes. Ultrasound is the first imaging method used in the diseases of superficial organs and tissues, including lymph nodes. The causes of mistakes can be either dependent or independent of the performing physician. The first group of mistakes includes inappropriate interpretation of images of anatomical structures, while the latter group includes, among other things, similar ultrasound images of different pathologies. For instance, a lymph node, whether normal or abnormal, may be mimicked by anatomical structures, such as a partially visible, compressed vein. Lymph nodes in lymphomas may be indistinguishable from reactive lymph nodes, even when using Doppler option, as well as morphologically difficult to distinguish from metastases. Metastatic lymph nodes can mimic e.g. nodular, separated postoperative thyroid fragments, a lateral neck cyst, chemodectoma (carotid body tumor) or neuroma. The appearance of lymph nodes in granulomatous diseases, such as tuberculosis or sarcoidosis, can be very similar to that of typical metastatic lymph nodes or lymphomas. Anechoic or hypoechoic areas in a lymph node can represent necrosis or metastatic hemorrhages, but also suppuration in inflamed lymph nodes. Lymph nodes in lymphomas, metastatic and reactive lymph nodes can adopt the classical characteristics of a simple cyst. The overall ultrasound picture along with all criteria for the assessment of a lymph node should be taken into account during ultrasound imaging. It seems that the safest management is to refer patients diagnosed with lymph node abnormalities for ultrasound-guided targeted fine needle aspiration biopsy followed by a total lymph node resection for histopathological examination in the case of suspected lymphoma.
PL
Przyczyną pomyłek w diagnostyce ultrasonograficznej wę- złów chłonnych położonych powierzchownie mogą być: • trudne warunki badania (techniczne lub ze strony osoby badanej); • nieznajomość anatomii prawidłowej; • nieznajomość cech obrazów USG w różnych chorobach węzłów chłonnych; • podobieństwo obrazów USG w różnych jednostkach chorobowych; • nieznajomość statystycznej częstości występowania chorób, ale również zbytnie sugerowanie się nią; • brak, zbyt mała liczba lub nieprawidłowość: danych z wywiadu, danych klinicznych, laboratoryjnych oraz wyników innych badań. Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/wydawnictwa/volume-17-no-68
Keywords
Discipline
Year
Volume
17
Issue
68
Pages
59–65
Physical description
Contributors
  • Department of Diagnostic Ultrasound, Masovian Bródnowski Hospital, Warsaw, Poland
  • Department of Diagnostic Imaging, Medical University of Warsaw, Poland
References
  • 1. Białek EJ, Jakubowski W, Szczepanik AB, Maryniak RK, Prochorec- -Sobieszek M, Bilski R et al.: Zastosowanie obrazowania harmonicznego i panoramicznego w ultrasonograficznej ocenie powierzchownych węzłów chłonnych. Ultrasonografia 2006; 27: 42–47.
  • 2. Bedi DG, Krishnamurthy R, Krishnamurthy S, Edeiken BS, Le-Petross H, Fornage BD et al.: Cortical morphologic features of axillary lymph nodes as a predictor of metastasis in breast cancer: in vitro sonographic study. AJR Am J Roentgenol 2008; 191: 646–652.
  • 3. Białek EJ, Jakubowski W, Szczepanik AB, Maryniak RK, Prochorec- -Sobieszek M, Bilski R et al.: Vascular patterns in superficial lymphomatous lymph nodes: a detailed sonographic analysis. J Ultrasound 2007; 10: 128–134.
  • 4. Białek EJ, Jakubowski W, Szczepanik AB, Maryniak RK, Prochorec- -Sobieszek M, Bilski R: Superficial lymph nodes involved by lymphoma in modern gray-scale ultrasound imaging. Pol J Radiol 2007; 72: 30–34.
  • 5. Tschammler A, Hahn D: Multivariate analysis of the adjustment of the colour duplex unit for the differential diagnosis of lymph node alterations. Eur Radiol 1999; 9: 1445–1450.
  • 6. Ying M, Ahuja AT, Evans R, King W, Metreweli C: Cervical lymphadenopathy: sonographic differentiation between tuberculous nodes and nodal metastases from non-head and neck carcinomas. J Clin Ultrasound 1998; 26: 383–389.
  • 7. Ahuja AT, Ying M, Yuen HY, Metreweli C: ‘Pseudocystic’ appearance of non-Hodgkin’s lymphomatous nodes: an infrequent finding with high- -resolution transducers. Clin Radiol 2001; 56: 111–115.
Document Type
article
Publication order reference
Identifiers
YADDA identifier
bwmeta1.element.psjd-7b2269f3-95cf-4772-90f8-d111c599a84f
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