title: Usefulness of ultrasonography for the evaluation of cervical lymphadenopathy.
abstract: OBJECTIVE
  To evaluate the role of ultrasonography for differentiating cervical lymphadenopathy due to tuberculosis, metastasis and lymphoma.
  
  
  METHODS
  Ultrasonography of the neck nodes was carried out prior to FNAC in 192 patients using a 10 mHz linear transducer. The sonographic findings were then correlated with the definitive tissue diagnosis obtained by FNAC or lymph node biopsy.
  
  
  RESULTS
  The most significant distinguishing feature was strong internal echoes seen in 84% of tubercular lymph nodes. This finding was found in only 11% of metastatic nodes and absent in lymphomatous nodes. The other findings such as L/S ratio, irregular margins, hypoechoic center, fusion tendency, peripheral halo and absent hilus were helpful in differentiating reactive from diseased nodes but showed considerable overlap in the 3 groups of tubercular, metastatic and lymphoma lymph nodes.
  
  
  CONCLUSIONS
  Ultrasonography is noninvasive and can give useful clues in the diagnosis of cervical lymphadenopathy. It should be interpreted in conjunction with FNAC result. Ideally ultra-sonographic guided FNAC should be obtained from the sonographically most representative node. In FNAC indeterminate cases, sonographic features may obviate the need for an invasive lymph node biopsy.
authors.affiliation: Department of Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221 005, India. dr_rahul_khanna@rediffmail.com
authors.forename: Rahul
authors.initials: R
authors.lastname: Khanna
authors.forename: Avinash Dutt
authors.initials: AD
authors.lastname: Sharma
authors.forename: Seema
authors.initials: S
authors.lastname: Khanna
authors.forename: Mohan
authors.initials: M
authors.lastname: Kumar
authors.forename: Ram C
authors.initials: RC
authors.lastname: Shukla
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D014463:Ultrasonography / Q000706:statistics & numerical data*; D055815:Young Adult