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© 2005 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 24:1385-1389 • 0278-4297

Ultrasonographic Differentiation Between Metastatic and Benign Lymph Nodes in Patients With Papillary Thyroid Carcinoma

Pedro Weslley Souza Rosário, PhD, Sérgio de Faria, MD, Luciano Bicalho, MD, Maria Flávia Gatti Alves, MD, Michelle Aparecida Ribeiro Borges, MD, Saulo Purisch, MD, Eduardo Lanza Padrão, MD, Leonardo Lamego Rezende, MD and Álvaro Luís Barroso, MD

Endocrinology Service, Santa Casa de Belo Horizonte, Minas Gerais, Brazil.

Address correspondence to Pedro Weslley Souza Rosário, PhD, Centro de Estudos e Pesquisa da Clinica de Endocrinologia e Metabologia, Avenida Francisco Sales 1111, 5 Andar Ala D, Santa Efigênia, 30150-221 Belo Horizonte-MG, Brazil. E-mail: pedrorosario{at}globo.com

Objective. The purpose of this study was to evaluate the ultrasonographic characteristics of metastatic lymph nodes in patients with papillary thyroid carcinoma. Methods. The ultrasonographic characteristics of lymph nodes were analyzed in 112 consecutive patients who underwent thyroidectomy and lymph node dissection, with the diagnosis being confirmed by anatomopathologic examination. Results. A total of 198 lymph nodes were metastatic, and 152 were benign (normal or with nonspecific lymphadenitis). Minimum axial diameters of 7 mm for level II (upper internal jugular chain) and 6 mm for the rest of the neck were observed in 93% of metastatic lymph nodes, absence of an echogenic hilum in 88%, hyperechogenicity in relation to the adjacent muscles in 86%, a round shape in 80%, calcifications in 49.5%, and intranodal cystic necrosis in 20%. These ultrasonographic characteristics were observed in 17%, 10%, 4.5%, 29.5%, 0%, and 0% of benign lymph nodes, respectively. Conclusions. Even basic ultrasonographic characteristics (shape, echogenicity and echogenic hilum, calcifications, and intranodal cystic necrosis) help in the differentiation between metastatic and nonmetastatic lymph nodes in patients with papillary thyroid carcinoma.

Key Words: lymph nodes • papillary carcinoma • ultrasonography

Abbreviations: FNAC, fine-needle aspiration cytologic examination • S/L, short axis/long axis




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