Ultrasound can be used to evaluate an enlarged lymph node. This can help with the decision to biopsy or aspirate a lymph node.
Lymph node location: neck
The expected findings in a lymph node:
(1) central vascularity
(2) echogenicity in the hilum
(3) somewhat symmetric cortical hypertrophy
Features associated with pathological lymph node on ultrasonography:
(1) increased short axis diameter, with the ratio of short to long axis diameters > 0.5 with malignancy.
(2) eccentric cortical hypertrophy
(3) extracapsular spread
(4) loss of echogenicity in the hilum
(5) necrosis within the node
(6) peripheral subcapsular vascularity
where:
• The Solbiati Index is a ratio of length to transverse diameters. A score < 2 is associated with malignancy. The ratio above is the inverse of the Solbiati Index.
Concern is increased if the lymph node enlargement:
(1) continues to progress
(2) is unexplained.
