JUM etoc signup
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kuna, S. K.
Right arrow Articles by Dodig, D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kuna, S. K.
Right arrow Articles by Dodig, D.
© 2006 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 25:1531-1537 • 0278-4297

Ultrasonographic Differentiation of Benign From Malignant Neck Lymphadenopathy in Thyroid Cancer

Sanja Kusacic Kuna, MD, Irena Bracic, MD, Vanja Tesic, MD, Krunoslav Kuna, MD, PhD, Gordana Horvatic Herceg, MD and Damir Dodig, MD, PhD

Clinical Department of Nuclear Medicine and Radiation Protection, University Hospital Rebro, Zagreb, Croatia (S.K.K., I.B., G.H.H., D.D.); Department of Epidemiology, Zagreb Public Health Institute, Zagreb, Croatia (V.T.); and University Hospital "Sestre Milosrdnice," Zagreb, Croatia (K.K.).

Address correspondence to Sanja Kusacic Kuna, MD, Clinical Department of Nuclear Medicine and Radiation Protection, University Hospital Rebro, Kispaticeva 12, 10 000 Zagreb, Croatia. E-mail: sanja.kusacic-kuna{at}zg.t-com.hr

Objective. The aim of this study was to determine whether ultrasonography itself was able to distinguish benign from malignant lymphadenopathy in patients with thyroid cancer. Methods. We evaluated lymph nodes in a group of patients with thyroid cancer. Nodes were detected and measured by ultrasonography, and their shape, echogenicity, size, and location were noted. Ultrasonographically guided fine-needle aspiration biopsy (FNAB) was performed, and smears were analyzed cytologically. Results. Ultrasonographically guided FNAB was performed in 578 neck nodes in a group of 631 patients with thyroid cancer. In most cases, metastases had a round shape and various echo structures, with a predomination of hypoechoic nodes without a hilum. There were statistical differences in size between metastatic and benign nodes in terms of maximum diameter, minimum diameter, and volume. Among these, minimum diameter and the shape of the nodes seemed to be the most reliable in suggesting malignancy. A round shape with a longitudinal/transverse ratio of less than 2 of hypoechoic nodes indicated the presence of metastases, and we then performed FNAB. The absence of an echogenic hilum and the presence of cystic portions and calcifications were significantly greater in malignancies than in benign lesions (P < .001). In most cases, metastatic nodules were situated in the lower third of the neck. Reactively enlarged nodes occurred more frequently in the upper part of the neck. Conclusions. Ultrasonography itself cannot distinguish benign from malignant lesions, but an echographic appearance suggests malignancy and helps in the selection of the node to aspirate with ultrasonographically guided FNAB, which is crucial for a final diagnosis.

Key Words: lymph nodes • thyroid cancer • ultrasonography

Abbreviations: FNAB, fine-needle aspiration biopsy • L/T, longitudinal/transverse




This article has been cited by other articles:


Home page
 J Ultrasound MedHome page
L. K. Shin, N. J. Fischbein, M. J. Kaplan, and R. B. Jeffrey
Metastatic Squamous Cell Carcinoma Presenting as Diffuse and Punctate Cervical Lymph Node Calcifications: Sonographic Features and Utility of Sonographically Guided Fine-Needle Aspiration Biopsy
J. Ultrasound Med., December 1, 2009; 28(12): 1703 - 1707.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Roentgenol.Home page
J. S. Park, K.-R. Son, D. G. Na, E. Kim, and S. Kim
Performance of Preoperative Sonographic Staging of Papillary Thyroid Carcinoma Based on the Sixth Edition of the AJCC/UICC TNM Classification System
Am. J. Roentgenol., January 1, 2009; 192(1): 66 - 72.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
N. A. Johnson and M. E. Tublin
Postoperative Surveillance of Differentiated Thyroid Carcinoma: Rationale, Techniques, and Controversies
Radiology, November 1, 2008; 249(2): 429 - 444.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
S. Leboulleux, E. Girard, M. Rose, J. P. Travagli, N. Sabbah, B. Caillou, D. M. Hartl, N. Lassau, E. Baudin, and M. Schlumberger
Ultrasound Criteria of Malignancy for Cervical Lymph Nodes in Patients Followed Up for Differentiated Thyroid Cancer
J. Clin. Endocrinol. Metab., September 1, 2007; 92(9): 3590 - 3594.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American Institute of Ultrasound in Medicine.