PURPOSE: In vitro sonography of lymph nodes was performed to ascertain the differential point between benignancy and malignancy. MATERIALS AND METHODS: Ninty-one lymph nodes were obtained at gastric cancer surgery and pathologically proved as benignancy in 68 and malignancy in 23 cases. Sohographic and pathologic correlation of resected ninty one lymph nodes was done in terms of size, the ratio of longest diameter versus shortest diameter, central hyperechogenicity, and peripheral cortical echo. RESULTS: Sonographic findings of benign lymph node were small size, oval shape(85%), narrow central high echogenicity(44%), and symmetric cortical thickening(41%). Sonographic findings of malignant lymph node were large size, round contour(39%), loss of central high echogenicity(82%), and diffuse increase of cortical thickness(82%). CONCLUSION: The most reliable sonographic criterion for differentiation of benignancy from malignancy was size of a lymphnode.
Lymph Nodes* ; Stomach Neoplasms ; Ultrasonography

Lymph nodes (LNs) containing echogenic deposits is a specific ultrasonographic (US) finding of pathologic LNs. Here, I reported on a case of hyperechoic cervical lymph nodes after injection of silicone into the face. US showed globally or partially hyperechoic cervical LNs with hyperechoic tapering trails. This is the first description of ultrasonographic findings and the pathologic correlation for LNs affected by migration of liquid injectable silicone into the neck.
Lymph Nodes* ; Neck ; Silicones* ; Ultrasonography

The diagnosis of breast lymphoma is a prime consideration when a breast mass develops in a patient with a history of lymphoma either in lymphatic system or at other anatomic sites, with bilateral axillary lymph nodes enlargment. However, the radiologic findings of lymphoma in breast are known as non-specific. Breast lymphoma is extremely rare and it has never been reported in this country. We report two cases of breast lymphoma with mammographic and sonographic findings.
Breast* ; Diagnosis ; Humans ; Lymph Nodes ; Lymphatic System ; Lymphoma* ; Ultrasonography

BACKGROUND AND AIMS: The precise preoperative staging of rectal cancer is of great im-portance for the selection of an appropriate treatment. Endorectal ultrasonography (EUS) has been proven as an efficient tool for staging in rectal cancer. Moreover, its technical advancement has been enhancing resolution and applications. We evaluated the accuracy of preoperative staging using EUS in rectal cancer and examined whether staging by EUS was an efficient procedure. METHODS: EUS was performed in 79 patients with rectal cancer diagnosed by colonoscopic biopsy from January to December, 1996. Endoscopic examina-tion was used with Olympus, GF-UM20 and Br?l and Kjaer type 2001 Scanner. The staging by EUS was based on UICC classification. RESULTS: Preoperative staging by EUS was equal to pathologic staging in 70.9% (56/79) of cases. Overstaging was found in 17.7% (14/79) and downstaging in 11.4% (9/79). The prediction of lymph node metastases was accurate in 50 of 79 cases (63.3%). CONCLUSION: EUS seems to be an efficient diagnostic method to assess rectal cancer staging. More accurate imaging and further experience in the interpretation is needed to improve the efficacy of EUS.
Biopsy ; Classification ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Rectal Neoplasms* ; Ultrasonography*

PURPOSE: The purpose of this study was to evaluate how the anisotropy and the static stretch stress of the cervical musculature influence the measured shear modulus in a tissue-mimicking phantom and in cervical lymph nodes in vivo by using shear wave elastography (SWE). METHODS: SWE was performed on a phantom using a pig muscle and on the middle jugular cervical lymph nodes in six volunteers. Tissue elasticity was quantified using the shear modulus and a supersonic shear wave imaging technique. For the phantom study, first, the optimal depth for measurement was determined, and then, SWE was performed in parallel and perpendicular to the muscle fiber orientation with and without strain stress. For the in vivo study, SWE was performed on the cervical lymph nodes in parallel and perpendicular to the sternocleidomastoid muscle fiber direction with and without neck stretching. The mean values of the shear modulus (meanSM) were then analyzed. RESULTS: In the phantom study, the measured depth significantly influenced the meanSM with a sharp decrease at the depth of 1.5 cm (P<0.001). Strain stress increased the meanSM, irrespective of the muscle fiber orientation (P<0.001). In the in vivo study, the meanSM values obtained in parallel to the muscle fiber orientation were greater than those obtained perpendicular to the fiber orientation, irrespective of the stretch stress (P<0.001). However, meanSM was affected significantly by the stretch stress parallel to the muscle fiber orientation (P<0.001). CONCLUSION: The anisotropic nature of the cervical musculature and the applied stretch stress explain the variability of the SWE measurements and should be identified before applying SWE for the interpretation of the measured shear modulus values.
Anisotropy* ; Elasticity ; Elasticity Imaging Techniques* ; Lymph Nodes* ; Neck* ; Ultrasonography* ; Volunteers

The purpose of our study is to evaluate the diagnostic performance of radiomics in multi-class discrimination of lymphadenopathy based on elastography and B-mode dual-modal ultrasound images. We retrospectively analyzed a total of 251 lymph nodes (89 benign lymph nodes, 70 lymphoma and 92 metastatic lymph nodes) from 248 patients, which were examined by both elastography and B-mode sonography. Firstly, radiomic features were extracted from multimodal ultrasound images, including shape features, intensity statistics features and gray-level co-occurrence matrix texture features. Secondly, three feature selection methods based on information theory were used on the radiomic features to select different subsets of radiomic features, consisting of conditional infomax feature extraction, conditional mutual information maximization, and double input symmetric relevance. Thirdly, the support vector machine classifier was performed for diagnosis of lymphadenopathy on each radiomic subsets. Finally, we fused the results from different modalities and different radiomic feature subsets with Adaboost to improve the performance of lymph node classification. The results showed that the accuracy and overall 1 score with five-fold cross-validation were 76.09%±1.41% and 75.88%±4.32%, respectively. Moreover, when considering on benign lymph nodes, lymphoma or metastatic lymph nodes respectively, the area under the receiver operating characteristic curve of multi-class classification were 0.77, 0.93 and 0.84, respectively. This study indicates that radiomic features derived from multimodal ultrasound images are benefit for diagnosis of lymphadenopathy. It is expected to be useful in clinical differentiation of lymph node diseases.
Elasticity Imaging Techniques ; Humans ; Lymph Nodes ; Lymphadenopathy ; Retrospective Studies ; Ultrasonography

Ultrasound (US) elastography has been introduced as a noninvasive imaging technique for evaluating cervical lymph nodes. US elastography techniques include strain elastography and shear wave-based elastography. The application of this technique is based on the fact that stiff tissues tend to deform less and show less strain than compliant tissues when the same force is applied. In general, metastatic lymph nodes demonstrate higher stiffness than benign lymph nodes. Overall, preliminary studies suggest that US elastography may be useful in differentiating benign and malignant cervical lymph nodes, thereby informing decisions to perform a biopsy and facilitating follow-up. For US elastography to be accepted into clinical practice, however, its techniques, associated diagnostic criteria, and reliability need to be further refined.
Biopsy ; Elasticity Imaging Techniques* ; Lymph Nodes* ; Neck ; Ultrasonography*

PURPOSE: Lateral lymph node metastasis of papillary thyroid cancer (PTC) is indicative of tumor aggressiveness and can determine treatment strategies. However, the role of prophylactic lateral lymph node dissection in the management of PTC is unclear. This study evaluated factors predictive of lateral lymph node metastasis in patients with suspicious lymph node enlargement in preoperative imaging. METHODS: This retrospective study included 728 patients with newly diagnosed PTC who underwent therapeutic surgery. Clinicopathologic results were reviewed, and factors predictive of lateral lymph node metastasis were analyzed. RESULTS: Of the 242 patients with lymph node metastasis, 50 had lateral lymph node metastasis. Lateral lymph node metastasis was associated with sex, tumor size, preoperative thyroid stimulating hormone (TSH) concentration and presence of central lymph node metastasis. Among patients with suspicious lateral lymph node metastasis by ultrasonography, high TSH level (odds ratio 3.833, P=0.031) and number of metastatic central lymph nodes (odds ratio 3.68, P=0.025) were significantly predictive of lateral lymph node metastasis. CONCLUSION: High serum TSH level and central lymph node metastasis were predictive of lateral lymph node metastasis in PTC patients with suspicious preoperative imaging findings. These predictive factors might help reduce unnecessary therapeutic lateral lymph node dissection.
Humans ; Lymph Node Excision ; Lymph Nodes* ; Neoplasm Metastasis* ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyrotropin ; Ultrasonography

There is paucity in the literature on the use of endoscopic ultrasound (EUS) for evaluating the thyroid gland. We report the first case of primary papillary thyroid cancer diagnosed by using EUS and fine needle aspiration (FNA). A 66-year-old man underwent EUS for the evaluation of mediastinal lymphadenopathy. FNA of the lymph nodes showed benign findings. A hypoechoic mass was noted in the right lobe of the thyroid gland. Therefore, FNA was performed. The cytological results were consistent with primary papillary thyroid cancer.
Aged ; Biopsy, Fine-Needle* ; Endosonography ; Esophagus ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Thyroid Gland ; Thyroid Neoplasms* ; Ultrasonography*

PURPOSE: Acute abdominal pain in an epidemic aseptic meningitis which is mostly an enterovirus as causative agent, is noted in 23-55% of patients. An enterovirus is also known as one of the causes of acute nonspecific mesenteric lymphadenitis(ANML). The purpose of this study was to see if ANML was associated with acute abdominal pain in epidemic aseptic meningitis. METHODS: Between June 2001 and July 2001, data from 30 patients, aged 3 years to 14 years, with aseptic meningitis was reviewed. Abdominal ultrasonography was performed on all the patients and ANML was defined as a cluster of five or more lymph nodes measuring 5 mm or greater in their longitudinal diameter in the right lower quadrant with no identifiable specific inflammatory process. RESULTS: The clinical symptoms of the 30 patients were:fever(76.7%), vomiting(90.0%), diarrhea(20.0%) and abdominal pain(40.0%). The average peripheral blood leukocytes count on admission was 7,996+/-2,701(4,500-14,500)/mm(3). ANML, according to the ultrasonography, was shown in 93.3% of aseptic meningitis patients; the number of mesenteric nodes was 9.2+/-5.3(5-20), with 7.4% of the 27 control cases being mesenteric nodes positive(P<0.05). The patients with ANML were divided into two groups; those with and without abdominal pain, 42.9% and 57.1% respectively. Two patients without ANML showed no abdominal pain. The count of mesenteric nodes was not significantly correlated with the duration to diagnosis, with or without fever, peripheral blood leukocytes count, and with or without abdominal pain. CONCLUSION: ANML is presumed to be a cause of the acute abdominal pain in epidemic aseptic meningitis. Further clinical observations are recommended on the reason why ANML can be associated with and without abdominal pain.
Abdominal Pain* ; Diagnosis ; Enterovirus ; Fever ; Humans ; Leukocytes ; Lymph Nodes ; Meningitis ; Meningitis, Aseptic* ; Mesenteric Lymphadenitis* ; Ultrasonography