Year : 2019

Volume : Volume 10

Issue : Issue 1s

Address for correspondence :
Dr. A Priyadharshini.
apriya.omdr@gmail.com

Abstract

Background:  To emphasize the sensitivity and specificity of greyscale ultrasonography (USG) in detecting the reactive and metastatic cervical lymph nodes and as a good indicator for diagnosis and treatment planning. Materials and Methods: 30 patients divided into 3 Groups. Group I - 10 healthy individuals, Group II - 10 patients with head and neck infections, Group III - 10 patients with head and neck malignancy. Patients were subjected to clinical examination before USG and Fine needle aspiration cytology (FNAC) procedure. All sonographically detectable cervical lymph nodes in each region were assessed for size, shape, border, hilum, echogenicity and intranodal necrosis. Fine needle aspiration was done in the involved cervical lymph node for histopathological evaluation. Results: The sensitivity and specificity of ultrasonography in differentiating reactive cervical lymph nodes from metastatic cervical lymph nodes were for size 86.1% & 68.8% respectively, for shape 92.2% & 86.5% respectively, for border 96% & 97 % respectively, for hilum 100% & 100% respectively, for internal echogenicity 77% & 100% respectively, for intranodal necrosis 41.2% &100% respectively. Conclusion: This study helps to differentiate the reactive cervical lymph nodes from the metastatic lymph nodes by using Greyscale USG which was confirmed by FNAC. The ultrasonographic features of lymph nodes with round shape, absence of hilar echo, sharp nodal borders, hyperechoic internal echogenicity and presence of intranodal necrosis were highly suggestive of metastatic cervical lymph nodes whereas lymph nodes with oval shape, presence of hilar echo, smooth nodal borders, hypoechoic internal echogenicity and absence of intra nodal necrosis were suggestive of reactive cervical lymph nodes.

Keywords: Greyscale Ultrasonography, FNAC, Metastatic cervical lymph nodes, reactive cervical lymph nodes.