title: Ultrasonographic differentiation between metastatic and benign lymph nodes in patients with papillary thyroid carcinoma.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the ultrasonographic characteristics of metastatic lymph nodes in patients with papillary thyroid carcinoma.
  
  
  METHODS
  The ultrasonographic characteristics of lymph nodes were analyzed in 112 consecutive patients who underwent thyroidectomy and lymph node dissection, with the diagnosis being confirmed by anatomopathologic examination.
  
  
  RESULTS
  A total of 198 lymph nodes were metastatic, and 152 were benign (normal or with nonspecific lymphadenitis). Minimum axial diameters of 7 mm for level II (upper internal jugular chain) and 6 mm for the rest of the neck were observed in 93% of metastatic lymph nodes, absence of an echogenic hilum in 88%, hyperechogenicity in relation to the adjacent muscles in 86%, a round shape in 80%, calcifications in 49.5%, and intranodal cystic necrosis in 20%. These ultrasonographic characteristics were observed in 17%, 10%, 4.5%, 29.5%, 0%, and 0% of benign lymph nodes, respectively.
  
  
  CONCLUSIONS
  Even basic ultrasonographic characteristics (shape, echogenicity and echogenic hilum, calcifications, and intranodal cystic necrosis) help in the differentiation between metastatic and nonmetastatic lymph nodes in patients with papillary thyroid carcinoma.
authors.affiliation: Centro de Estudos e Pesquisa da Clinica de Endocrinologia e Metabologia, Avenida Francisco Sales 1111, 5 Andar Ala D, Santa Efigênia, 30150-221 Belo Horizonte-MG, Brazil. pedrorosario@globo.com
authors.forename: Pedro Weslley Souza
authors.initials: PW
authors.lastname: Rosário
authors.forename: Sérgio
authors.initials: S
authors.lastname: de Faria
authors.forename: Luciano
authors.initials: L
authors.lastname: Bicalho
authors.forename: Maria Flávia Gatti
authors.initials: MF
authors.lastname: Alves
authors.forename: Michelle Aparecida Ribeiro
authors.initials: MA
authors.lastname: Borges
authors.forename: Saulo
authors.initials: S
authors.lastname: Purisch
authors.forename: Eduardo Lanza
authors.initials: EL
authors.lastname: Padrão
authors.forename: Leonardo Lamego
authors.initials: LL
authors.lastname: Rezende
authors.forename: Alvaro Luís
authors.initials: AL
authors.lastname: Barroso
mesh_terms: D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging* / Q000473:pathology; D002574:Cervical Vertebrae; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008199:Lymphadenitis / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography