OBJECTIVE: To investigate the value of lymphatic contrast-enhanced ultrasound (LCEUS) with intra-glandular injection of contrast agent for diagnosis of central compartment lymph node metastasis of thyroid cancer. METHODS: From November, 2020 to May, 2022, the patients suspected of having thyroid cancer and scheduled for biopsy at our center received both conventional ultrasound and LCEUS examinations of the central compartment lymph nodes before surgery. All the patients underwent surgical dissection of the lymph nodes. The perfusion features in LCEUS were classified as homogeneous enhancement, heterogeneous enhancement, regular/irregular ring, and non-enhancement. With pathological results as the gold standard, we compared the diagnostic ability of conventional ultrasound and LCEUS for identifying metastasis in the central compartment lymph nodes. RESULTS: Forty-nine patients with 60 lymph nodes were included in the final analysis. Pathological examination reported metastasis in 34 of the lymph nodes, and 26 were benign lymph nodes. With ultrasound findings of heterogeneous enhancement, irregular ring and non-enhancement as the criteria for malignant lesions, LCEUS had a diagnostic sensitivity, specificity and accuracy of 97.06%, 92.31% and 95% for diagnosing metastatic lymph nodes, respectively, demonstrating its better performance than conventional ultrasound (P < 0.001). Receiver-operating characteristic curve analysis showed that LCEUS had a significantly greater area under the curve than conventional ultrasound for diagnosing metastatic lymph nodes (94.7% [0.856-0.988] vs 78.2% [0.656-0.878], P=0.003). CONCLUSION LCEUS can enhance the display and improve the diagnostic accuracy of the central compartment lymph nodes to provide important clinical evidence for making clinical decisions on treatment of thyroid cancer.
Humans ; Lymphatic Metastasis/diagnostic imaging* ; Thyroid Neoplasms/pathology* ; Ultrasonography/methods* ; Lymph Nodes/pathology* ; ROC Curve

Cervical nodal metastases are common in patients with head and neck cancers. Early assessment is important for treatment planning and prognosis. Ultrasound has been widely used in the evaluation of neck lymph nodes, with common parameters including location, size, shape, boundary, hilus, echogenicity, vascular pattern, and resistance index. The diagnostic accuracy has been dramatically improved along with the introduction of new techniques including contrast-enhanced ultrasound, elastography, and ultrasound-guided fine needle aspiration biopsy. Neck ultrasound has became an important tool in preoperative assessment and postoperative follow-up for patients with head and neck cancers.
Head and Neck Neoplasms ; pathology ; Humans ; Lymph Nodes ; diagnostic imaging ; pathology ; Lymphatic Metastasis ; diagnostic imaging ; pathology ; Neck ; diagnostic imaging ; pathology ; Ultrasonography

PURPOSE: The purpose of this study was to describe the mammographic and sonographic appearances and the clinical-pathologic features of invasive micropapillary carcinoma. MATERIALS AND METHODS: Between December 1999 and March 2005, among the 3,109 patients who underwent operation for breast cancer, 25 patients proved to have invasive micropaillary carcinoma. Among the 25 patients, we included 22 patients (mean age: 48, range: 26-77 years) who had undergone preoperative mammography and ultrasound. The mammographic and sonographic findings of the lesions were analyzed retrospectively. The pathologic findings were analyzed via the clinical records and pathology reports. RESULTS: Patients manifested with a palpable mass (77%, 17/22), bloody nipple discharge (14%, 3/22) or incidental lesion on the screening mammography (9%, 2/22). On mammography, a mass with an irregular (86%, 12/14) shape and an indistinct (43%, 6/14) or spiculated (43%, 6/14) margin was the most common findings on mammography. On sonography, a hypoechoic (91%, 20/22) mass with irregular shape (73%, 16/22) and an indistinct (32%, 7/22) or microlobulated (32%, 7/22) margin was the most common finding. Pathologically, axillary lymph node metastasis was present in 73% (16/22) of the patients. CONCLUSION: Invasive micropapillary carcinoma appeared an irregular shaped mass with an indistinct margin mass or microcalcifications on mammography and/or sonography. The tumors were frequently associated with axillary lymph node metastasis.
Breast Neoplasms ; Breast* ; Humans ; Lymph Nodes ; Mammography ; Mass Screening ; Neoplasm Metastasis ; Nipples ; Pathology ; Retrospective Studies ; Ultrasonography

PURPOSE: Increased technologic capabilities have allowed for the expanded use of ultrasound beyond simple differentiation of a lesion as solid versus cystic nature, allowing us to classify lesions into various categories based on a number of descriptive features. The purpose of this study was to investigate whether to predict the preoperative prognosis of breast cancer through the correlation between ultrasonographic images and the grade of malignancy. MATERIALS AND METHODS: The patient population for this study consisted of 107 patients with infiltrative ductal carcinoma who were evaluated using ultrasound technology. Ultrasonographic findings were divided as follows: Type I, round or oval shape and regular border; Type II, partially round or oval shape and partially irregular border; and Type III, irregular shape and irregular border. RESULTS: 1. The frequency of grade 1 (G1) was significantly higher in the Type I group than the othergroups. 2. In the 2.0 cm sized mass, the lymph node metastasis rate was significantly lower in the Type I group than the other groups. 3. In all the groups, Estrogen receptor (ER) positivity was insignificant regardless of tumor size and type. 4. In the 2.0 cm sized mass, c-erbB-2 positivity was significantly lower in the Type I than the other groups. There was no clear difference among the three groups in tumors greater than 2.0 cm in size. CONCLUSION: These results show that our classification of ultrasonographic images reflect the grade of malignancy in terms of clinicopathological features in breast cancers less than 2.0 cm in size. Therefore, ultrasonographic findings may help predict the preoperative prognosis in T1 size breast cancer, although further study is required.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Classification ; Diagnosis ; Estrogens ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Pathology ; Prognosis ; Ultrasonography

OBJECTIVE: To compare sonography and mammography in terms of their diagnostic value in breast cancer cases which initially presented as an axillary mass without a palpable mass or other clinical symptoms. MATERIALS AND METHODS: Seven patients with enlarged axillary lymph nodes who first presented with no evidence of palpable breast lesions and who underwent both mammography and sonography were enrolled in this study. In six of the seven, the presence of metastatic adenocarcinoma was confirmed preoperatively by axillary needle aspiration biopsy; in four, subsequent sonographicallyguided breast core biopsy performed after careful examination of the primary site indicated that primary breast cancer was present. In each case, the radiologic findings were evaluated by both breast sonography and mammography. RESULTS: Breast lesions were detected mammographically in four of seven cases (57%); in three of the four, the lesion presented as a mass, and in one as microcalcification. In three of these four detected cases, fatty or scattered fibroglandular breast parenchyma was present; in one, the parenchyma was dense. In the three cases in which lesions were not detected, mammography revealed the presence of heterogeneously dense parenchyma. Breast sonography showed that lesions were present in six of seven cases (86%); in the remaining patient, malignant microcalcification was detected at mammography. Final pathologic examination indicated that all breast lesions except one, which was a ductal carcinoma in situ, with microinvasion, were infiltrating ductal carcinomas whose size ranged from microscopic to greater than 3 cm. At the time of this study, all seven patients were alive and well, having been disease free for up to 61 months after surgery. CONCLUSION: In women with a palpable axillary mass confirmed as metastatic adenocarcinoma, breast sonography may be a valuable adjunct to mammography.
Adenocarcinoma/radiography/secondary/*ultrasonography ; Adult ; Axilla/*pathology ; Biopsy, Needle ; Breast/*pathology ; Breast Neoplasms/pathology/radiography/*ultrasonography ; Carcinoma, Infiltrating Duct/pathology/radiography/*ultrasonography ; Carcinoma, Intraductal, Noninfiltrating/pathology/radiography/*ultrasonography ; Female ; Human ; Lymph Nodes/radiography/*ultrasonography ; Mammography ; Middle Age ; Ultrasonography, Mammary

PURPOSE: The presence of lymph node metastasis is a key factor for deciding upon radical axillary dissection during a breast cancer operation. We performed prospective research to assess the accuracy and effectiveness of ex vivo ultrasound for detecting sentinel node metastasis during the operation. METHODS: 183 fresh sentinel lymph nodes from 30 breast cancer patients had sonographic examination performed on them by a specialized radiologist immediately after surgical resection. The sonographic criteria for malignant lymph nodes were uneven cortical thickness, a node more than 3 mm in diameter, the absence of the hilum and a round hypoechoic node. After sonographic evaluation, the specimen were delivered to the department of pathology for frozen biopsy and permanent staining. RESULTS: Among 133 lymph nodes that were examined on frozen sectioning, 12 (9.0%) were revealed as metastatic nodes and 121 (90.9%) were revealed as benign. On US examination, 150 (81.9%) among the detected 183 nodes were read as benign and 33 (18.1%) were read as metastatic. Among 150 benign nodes, four (2.6%) were proven as metastasis on permanent pathology, and 20 (60.6%) among the 33 sonographic cancerous nodes were reported as metastatic nodes. The sensitivity, specificity, positive predictive value, negative predictive value, false positive rate, false negative rate and accuracy of ex vivo ultrasound were 83.3%, 91.8%, 60.6%, 97.3%, 8.2%, 16.7% and 90.7% respectively. CONCLUSION: Ex vivo ultrasound evaluation for detecting sentinel lymph node metastasis during the operation may be helpful to decide the extent of lymph node dissection.
Biopsy ; Breast Neoplasms* ; Breast* ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis* ; Pathology ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography*

OBJECTIVETo study the value of contrast-enhanced ultrasound in tuberculous cervical lymph node biopsy.

METHODSSeventy-nine patients with cervical lymph node were divided into two groups. The lymph nodes of group A were used as real-time ultrasound guided biopsy; the lymph nodes of group B were contrast-enhanced ultrasound firstly to determine the target lymph node and the puncture point, then were detected with needle biopsy.

RESULTSGroup A: for the 23 lymph nodes of 23 patients, the rate of intact tissue was 52.1% and the positive rate of pathological diagnosis was 73.9%. Group B: for the 56 lymph nodes of 56 patients, the rate of intact tissue was 98.2% and the positive rate of pathological diagnosis was 100% (Chi square value was 23.37 and 12.31, P < 0.05).

CONCLUSIONThe application of contrast-enhanced ultrasound before cervical lymph node biopsy can obviously improve the rate of intact tissue and the positive rate of pathological diagnosis.

Adolescent ; Adult ; Female ; Humans ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Sentinel Lymph Node Biopsy ; methods ; Tuberculosis, Lymph Node ; pathology ; Ultrasonography, Doppler ; Young Adult

Sentinel lymph nodes (SLNs) are the first station of lymph nodes that extend from the breast tumor to the axillary lymphatic drainage. The pathological status of these LNs can predict that of the entire axillary lymph node. Therefore, the accurate identification of SLNs is necessary for sentinel lymph node biopsy (SLNB) to replace axillary lymph node dissection (ALND). The quality of life and prognosis of breast cancer patients are related to proper surgical treatment after the precise identification of SLNs. Some of the SLN tracers that have been identified include radioisotope, nano-carbon, indocyanine green (ICG), and methylene blue (MB). However, these tracers have certain limitations, such as pigmentation, radiation dangers, and the requirement for costly detection equipment. Ultrasound contrast agents (UCAs) have good specificity and sensitivity, and thus can compensate for some shortcomings of the mentioned tracers. This technique is also being applied to SLNB in patients with breast cancer, and can even provide an initial judgment on SLN status. Contrast-enhanced ultrasound (CEUS) has the advantages of high distinguishability, simple operation, no radiation harm, low cost, and accurate localization; therefore, it is expected to replace the traditional biopsy methods. In addition, it can significantly enhance the accuracy of SLN localization and shorten the operation time.
Humans ; Female ; Sentinel Lymph Node/pathology* ; Breast Neoplasms/pathology* ; Quality of Life ; Sentinel Lymph Node Biopsy/methods* ; Ultrasonography/methods* ; Lymph Nodes/surgery*

PURPOSE: To evaluate the safety and efficiency of the Ultrasound (US)-guided large needle core biopsy of axilla lymph nodes. MATERIALS AND METHODS: From March 2004 to September 2005, 31 patients underwent the US-guided core biopsy for axilla lymph nodes. Twenty five lesions out of 31 were detected during breast US, and 6 of 31 cases were palpable. Lymph nodes were classified based on their shape and cortical morphology. The core biopsy of axilla lymph nodes was performed on suspicious lymph nodes found during breast ultrasonography to find out whether the patients had a history of breast cancer or not. Among the 31 patients, 16 patients were associated with breast cancer. The lesion sizes varied from 0.6cm to 3.3cm (mean = 1.59 +/- 0.76cm). US-guided core biopsies were performed with 14G needles with an automated biopsy gun. Total 3 or 5 specimens were obtained. RESULTS: Among the 31 cases of axilla lymph nodes core biopsies, 11 cases showed malignant pathology. Seven out of 11 cases were metastatic lymph nodes from breast cancer; 2 cases were from primary unknown and 2 cases from lymphomas. On the other hand, 20 histopathologic results of axilla lesions were benign: subacute necrotizing lymphadenitis (n=2), dermatopathic lymphadenitis (n=1), reactive hyperplasia (n=10) and free of carcinoma (n=7). CONCLUSION: The US-guided large needle core biopsy of axilla lesions is safe and effective for the pathological evaluation. The core biopsy is believed to be easy to perform if suspicious lymph nodes or mass lesions are found in the axilla.
Adult ; *Axilla ; Biopsy, Needle/*methods ; Breast/pathology ; Female ; Humans ; Lymph Nodes/*pathology ; Middle Aged ; Reproducibility of Results ; Ultrasonography, Mammary/*methods

Castleman's disease is a rare benign lymphoproliferative disorder of uncertain origin which most commonly involves the mediastinum but rarely affects the axilla. We report a case of localized Castleman's disease involving the axillary lymph node. Mammography revealed a well-defined, homogeneously dense ovoid mass, 3 cm in size, in the left axilla, while gray-scale ultrasonography (US) demonstrated a well-defined, uniformly hypoechoic ovoid mass with good through transmission. Peripheral hypervascularity was observed at power Dopper US, and early rapid homogeneous enhancement at contrast-enhanced dynamic CT.
Axilla ; Case Report ; Female ; Giant Lymph Node Hyperplasia/*diagnosis/radiography/ultrasonography ; Human ; Lymph Nodes/*pathology ; Middle Age ; *Tomography, X-Ray Computed ; *Ultrasonography, Doppler