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Scholars Journal of Applied Medical Sciences | Volume-5 | Issue-11
Benign Versus Malignant Cervical Lymphadenopathy on Ultrasound and Doppler- A Case Series
Dr. Jayesh Sunil Ajwani, Dr. Sanjay M. Khaladkar, Dr. Foram Doshi
Published: Nov. 30, 2017 |
291
201
DOI: 10.36347/sjams.2017.v05i11.059
Pages: 4611-4621
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Abstract
A prospective study was conducted on 50 patients for a period of two years at Dr.D.Y.Patil Medical College, Hospital and Research Centre, Pimpri on Aloka Arietta S 60 USG machine to differentiate between malignant and benign cervical lymphadenopathy by B-mode, colour doppler and power doppler. Out of total 50 patients, 30 were males (60%) and 20 (40%) were females. The mean age for malignant group of lymph nodes was 42.89 and for benign group of lymph nodes were 31.22. Malignant group of lymph nodes accounted for 36% and benign group of lymph nodes accounted for 64% of cases. Maximum number of lymph nodes were in the upper cervical region (42.5%), followed by supraclavicular region (17.50%). Malignant group of lymph nodes were those occurring from head and neck malignancies (55.55%), lymphoma (16.67%) and unknown primary (27.78%). Benign group of lymph nodes were due to specific infections namely tuberculosis (50%) and those occurring from non-specific infection (50%). Malignant group of lymph nodes had a mean S/L ratio of 0.63 and maximum number was round in shape (77.78%). Benign group of lymph nodes had a mean S/L ratio of 0.50. Benign group of lymph nodes were oval in shape in 90.62%. Maximum number of malignant lymph nodes had ill-defined margins (66.67%) with absence of fatty hilum (72.23%). Maximum number of benign lymph nodes had well-defined margins (93.75%) and absence of fatty hilum (53.12%). Maximum number of malignant lymph nodes were heterogeneous in echotexture (61.12%) followed by hypoechoic (33.34%). Maximum benign lymph nodes were heterogeneous in echotexture (53.12%) followed by hypoechoic (46.87%). Necrosis was present in 77.78% of malignant lymph nodes. In benign lymph nodes, necrosis was present in 50% cases. Majority of malignant group of lymph nodes showed mixed vascularity (77.78%). All reactive lymph nodes showed hilar vascularity while tuberculous lymph nodes were avascular.