title: Neck lymph nodes in chronic autoimmune thyroiditis: the sonographic pattern.
abstract: BACKGROUND
  Neck lymph nodes may be involved in the pathogenesis of chronic autoimmune thyroiditis (CAT). This study was undertaken to identify which of the sonographic features of cervical lymph nodes are readily applicable to patients affected by CAT compared to healthy control subjects.
  
  
  METHODS
  We recruited 106 patients (92 females and 14 males) with CAT and 70 control subjects (53 females and 17 males) without clinical, biochemical, and ultrasonographic evidence of thyroid and neck diseases. We performed laboratory tests (thyrotropin, antithyroperoxidase antibodies, antithyroglobulin antibodies, and ultrasonography) to evaluate in each group: (i) thyroid function, autoimmunity, and morphology; (ii) number, topographic distribution (levels I-VI), and morphology of neck nodes (long-axis diameter; short-axis diameter; short-axis/long-axis ratio; absence or presence of hilus).
  
  
  RESULTS
  Total number of neck nodes with long-axis diameter >10 mm was significantly higher in the CAT group than in the control group (mean±standard deviation [SD]: 3.7±2.4 vs. 0.8±1.3; p<0.001) with significantly increased differences in levels II (1.4±0.8 vs. 0.3±0.5; p<0.001), III (2±1.2 vs. 0.3±0.7; p<0.001), and IV (0.7±0.7 vs. 0.07±0.2; p<0.001). More nodes with a hilus were found in the CAT group than in the control group (mean number of nodes±SD: 2.8±1.9 vs. 0.7±1.1; p<0.001). Short-axis diameter of level III (4.4±1 vs. 3.7±1.2 mm; p=0.002) and level IV nodes (3.9±1 vs. 3.1±0.5 mm p=0.030) was increased in CAT patients when compared with healthy controls.
  
  
  CONCLUSIONS
  The present study is the first one aiming at a systematic description of the sonographic pattern of cervical lymph nodes in CAT. An increased number of benign hyperplastic neck nodes, especially in levels II-IV, appears to be a characteristic sonographic finding associated with CAT.
authors.affiliation: Department of Internal Medicine, Hospital of Partinico, Palermo, Italy. davide.brancato@libero.it
authors.forename: Davide
authors.initials: D
authors.lastname: Brancato
authors.forename: Roberto
authors.initials: R
authors.lastname: Citarrella
authors.forename: Pierina
authors.initials: P
authors.lastname: Richiusa
authors.forename: Marco Calogero
authors.initials: MC
authors.lastname: Amato
authors.forename: Calogero
authors.initials: C
authors.lastname: Vetro
authors.forename: Carla Giordano
authors.initials: CG
authors.lastname: Galluzzo
mesh_terms: D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008297:Male; D009333:Neck / Q000000981:diagnostic imaging*; D013961:Thyroid Gland / Q000000981:diagnostic imaging*; D013967:Thyroiditis, Autoimmune / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography