Does lymph node morphology using ultrasound reflect aetiology? A pictorial essay, part I

Trenker, Corinna; Görg, Christian; Hollerweger, Alois; Jenssen, Christian; Dong, Yi; Cui, Xin-Wu; Dietrich, Christoph F.

doi:10.11152/mu-2634

Cited by 4 publications

(6 citation statements)

References 32 publications

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“…As we know, the hypoechoic lymph node margins are the lymph node cortex in ultrasonography, which is mainly substantial tissue and histologically confirmed to be composed of lymphoid nodule. In contrast, the hyperechoic central of lymph nodes are formed by medullary sinuses, connective tissue, fat and arterial vasculature 28 . Therefore, it is probably because that the blood vessels in the hilum were completely invaded by the tumor tissue and replaced by immature neovascularization.…”

Section: Discussionmentioning

confidence: 99%

A model to predict the prognosis of diffuse large B-cell lymphoma based on ultrasound images

Chen

Zhou

et al. 2023

Sci Rep

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The purpose of this paper was to assess the value of ultrasonography in the prognosis of diffuse large b-cell lymphoma (DLBCL) by developing a new prognostic model. One hundred and eleven DLBCL patients with complete clinical information and ultrasound findings were enrolled in our study. Univariate and multivariate regression analyses were used to identify independent risk factors for progression-free survival (PFS) and overall survival (OS). Receiver operator characteristic (ROC) curves were plotted and the corresponding area under the curve (AUC) was calculated to assess the accuracy of the international prognostic index (IPI) and new model in DLBCL risk stratification. The results suggested that hilum loss and ineffective treatment were independent risk variables for both PFS and OS in DLBCL patients. Additionally, the new model that added hilum loss and ineffective treatment to IPI had a better AUC for PFS and OS than IPI alone (AUC: 0.90, 0.88, and 0.82 vs. 0.71, 0.74, and 0.68 for 1-, 3-, and 5-year PFS, respectively; AUC: 0.92, 0.85 and 0.86 vs. 0.71, 0.75 and 0.76, for 1-, 3-, and 5-year OS, respectively). The model based on ultrasound images could better suggest PFS and OS of DLBCL, allowing for better risk stratification.

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Section: Discussionmentioning

confidence: 99%

A model to predict the prognosis of diffuse large B-cell lymphoma based on ultrasound images

Chen

Zhou

et al. 2023

Sci Rep

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“…US guided fine needle or sometimes core needle biopsy is performed in cases of unexplained lymphadenopathy (3,9). US guidance allows precise sampling.…”

Section: Ultrasound Techniquesmentioning

confidence: 99%

“…Palpable masses can sometimes simulate lymph nodes even though they originate from other tissues (8). The most commonly encountered masses include: lipomas, abscesses, thyroglossal duct cysts, branchial cysts, dermoid cysts, thyroid nodules, vascular malformations, pilomatrixomas and others (3,9). In this pictorial essay, the US characteristics of normal superficial lymph nodes, as well as different lymphadenopathies, are described.…”

Section: Introductionmentioning

confidence: 99%

A Pictorial Essay on Ultrasonography of Lymphadenopathies in Children

Šljivić,

Pšeničny,

Glušič

et al. 2023

CEJP

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The purpose of this review is to become familiar with ultrasound (US) characteristics of normal and pathological lymph nodes and with diagnostic imaging approach to lymphadenopaties. Lymphadenopathy is a common finding in the paediatric population. Due to the many pathologies that can present in a similar fashion, imaging is a valuable method used in diagnostic process. Ultrasound is the modality of choice for lymph node detection in children, with a high safety profile as it does not use radiation. In this review the US appearance and characteristics of normal lymph nodes, and of some more common lymphadenopathies, are presented. Special attention is paid to distinguishing between benign and malignant lymph nodes on the basis of US characteristics. All findings must always be correlated with clinical and laboratory findings, and frequently followed by fine-needle aspiration or excisional biopsy as some US morphologies of benign and malignant nodes may overlap. However, the criteria that raise suspicion for malignancy are round shape, predominantly hypoechoic echogenicity, heterogenous echotexture, absent or displaced hilum, irregular outlines, necrosis, multiple confluent lymph nodes, the presence of microcalcifications, and peripheral or mixed flow pattern on colour Doppler imaging.Conclusion - US is the first line imaging method in palpable masses in children, first to confirm the presence of lymph nodes, and second to better delineate the lymph node’s characteristics, which guides further diagnostic decisions and treatment.

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“…Patients with incidentally discovered diffuse splenomegaly will usually require a full clinical, haematological, biochemical, microbiological and immunological assessment. Imaging studies may identify features of chronic liver disease/portal hypertension or may reveal multisystem disease-particularly lymphadenopathy (Trenker et al 2020a(Trenker et al , 2020b, primary or secondary malignancy or granulomatous disease-suggesting the underlying pathology (Pozo et al 2009). In the absence of focal splenic abnormality, the cause of isolated splenomegaly frequently cannot be determined with imaging studies alone.…”

Section: Splenomegalymentioning

confidence: 99%

WFUMB Position Paper—Incidental Findings, How to Manage: Spleen

Trenker

Görg

Freeman

et al. 2021

Ultrasound in Medicine & Biology

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The World Federation for Ultrasound in Medicine and Biology (WFUMB) is addressing the issue of incidental findings (IFs) with a series of publications entitled "Incidental Imaging Findings-The Role of Medical Ultrasound." IFs are less commonly encountered in the spleen than in many other abdominal organs but remain a frequent dilemma in clinical practice. A histological diagnosis is rarely necessary for patient management. Many IFs, such as secondary spleens and splenic cysts, are harmless and do not require any further investigation. The diagnosis of many other focal splenic lesions is, however, often problematic. The following overview is intended to illustrate a variety of incidentally detected spleen pathologies such as size variants, shape variants, secondary spleens, focal splenic lesions and splenic calcifications. It should aid the examiner in establishing the diagnosis. Moreover, it should help the ultrasound practitioner decide which pathologies need no further investigation, those requiring interval imaging and cases in which immediate further diagnostic procedures are required.In patients with splenomegaly (>13 £ 6 cm), an imaging, clinical and laboratory evaluation is usually required to determine the underlying cause.Most congenital variants of the spleen, and accessory spleens, have characteristic ultrasound appearances and do not require further evaluation or follow-up.The use of ultrasound contrast microbubbles (contrast-enhanced ultrasound) is of particular value in ultrasound imaging of the spleen when an indeterminate incidental finding is encountered.Splenosis can be confidently diagnosed with contrast-enhanced ultrasound and usually requires no additional imaging or follow-up.The cause of an inhomogeneous splenic parenchyma must be clarified, especially to exclude sarcoidosis or lymphomatous infiltration. Incidental indeterminate focal splenic lesions (with the exception of simple cysts) are often best managed by an interval follow-up examination (initially after 3 months) unless there clearly malignant clinical or sonographic features.For splenic calcifications, including the "starry sky" spleen, no follow-up is necessary.

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Does lymph node morphology using ultrasound reflect aetiology? A pictorial essay, part I

Cited by 4 publications

References 32 publications

A model to predict the prognosis of diffuse large B-cell lymphoma based on ultrasound images

A model to predict the prognosis of diffuse large B-cell lymphoma based on ultrasound images

A Pictorial Essay on Ultrasonography of Lymphadenopathies in Children

WFUMB Position Paper—Incidental Findings, How to Manage: Spleen

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