Evaluation of B-Mode and Color Doppler Ultrasound in the Diagnosis of Malignant Cervical Lymphadenopathy

Rohan, Kamat; Ananthakrishnan, Ramesh; Sureshkumar, Sathasivam; Vijayakumar, Chellappa; Abdulbasith, K M; Krishnaraj, Balamourougan

doi:10.7759/cureus.9819

Cited by 8 publications

(6 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, the number and location of the lymphadenopathies and the size of the mass were atypical for a vaccine-related cervical lymphadenopathy, which contributed to suspicion of malignant disease and further examinations. The shape of the lymphadenopathy on US, findings of eccentric cortical thickness, irregular margins, loss of an echogenic hilum, and increasing peripheral vascularity on a color Doppler scan are generally suggestive of malignancy (23,24). Of these findings, the mass in our case showed eccentric cortical thickness.…”

Section: Discussionmentioning

confidence: 57%

See 1 more Smart Citation

Rapid progression of marginal zone B-cell lymphoma after COVID-19 vaccination (BNT162b2): A case report

et al. 2022

View full text Add to dashboard Cite

B-cell lymphomas are neoplastic diseases occasionally associated with chronic inflammation. mRNA vaccines for coronavirus disease 2019 (COVID-19) induce inflammatory responses, which often lead to fever and lymphadenopathies indistinguishable from lymphomas. Although both lymphadenopathies and lymphomas can be influential, the correlation between them is unclear. Herein, we present the first case of marginal zone B-cell lymphoma following mRNA COVID-19 vaccination. An 80-year-old Japanese woman presented with a right temporal mass that appeared the morning after she was administered her first mRNA COVID-19 vaccination (BNT162b2). The mass gradually decreased in size but persisted over 6 weeks after her first vaccination (3 weeks after her second vaccination). At her first visit to our hospital, ultrasound revealed the size of the mass to be 28.5 × 5.7 mm, and computed tomography revealed multiple lymphadenopathies in the right parotid, submandibular, jugular, and supraclavicular regions. Initially, we suspected head-and-neck benign lymphadenopathy as a side effect of vaccination. Nine weeks later, the number of swollen submandibular and parotid glands increased, and the lymph nodes further enlarged. Finally, the right temporal mass was diagnosed as marginal zone B-cell lymphoma based on immunohistochemical and flow cytometry findings of biopsy specimens. Our findings suggest that although 4–6 weeks of observation for lymph node inflammation after the second vaccination is recommended, malignancy should also be considered in the differential diagnosis of lymphadenopathy following vaccination.

show abstract

Section: Discussionmentioning

confidence: 57%

“…The shape of the lymphadenopathy on US, findings of eccentric cortical thickness, irregular margins, loss of an echogenic hilum, and increasing peripheral vascularity on a color Doppler scan are generally suggestive of malignancy ( 23 , 24 ). Of these findings, the mass in our case showed eccentric cortical thickness.…”

Section: Discussionmentioning

confidence: 99%

Rapid progression of marginal zone B-cell lymphoma after COVID-19 vaccination (BNT162b2): A case report

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The presence of a polar feeding artery, a branch of the inferior thyroid artery, increases sensitivity by 10% and accuracy by 54% [31]. Thus, Doppler US imaging may help to distinguish suspected parathyroid lesions from other neck structures, such as the thyroid nodules (most commonly, peripheral vascularisation pattern) and lymph nodes (predominantly, hilar vascularisation) [32][33][34]. Additional US imaging modalities may help to distinguish between parathyroid lesions.…”

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Ultrasound Qualitative and Quantitative Characteristics of Parathyroid Gland Lesions

et al. 2021

View full text Add to dashboard Cite

Background and Objectives: preoperative differentiation of enlarged parathyroid glands may be challenging in conventional B-mode ultrasound. The aim of our study was to analyse qualitative and quantitative characteristics of parathyroid gland lesions, using multiparametric ultrasound protocol—B-mode, Colour Doppler (CD), and contrast-enhanced ultrasound (CEUS)—and to evaluate correlation with morphology in patients with hyperparathyroidism (HPT). Materials and Methods: consecutive 75 patients with 88 parathyroid lesions and biochemically confirmed HPT prior to parathyroidectomy were enrolled in the prospective study. B-mode ultrasound, CD, and CEUS were performed with the subsequent qualitative and quantitative evaluation of acquired data. We used 1 mL or 2 mL of intravenous ultrasound contrast agent during the CEUS examination. Correlation with post-surgical morphology was evaluated. Results: seventy parathyroid adenomas were hypoechoic and well contoured with increased central echogenicity (44.3%), peripheral-central vascularization (47%), and polar feeding vessel (100%). Twelve hyperplasias presented with similar ultrasound appearance and were smaller in volume (p = 0.036). Hyperplasias had a tendency for homogenous, marked intense enhancement vs. peripherally enhanced adenomas with central wash-out in CEUS after quantitative analysis. No significant difference was observed in contrasting dynamics, regardless of contrast media volume use (1 mL vs. 2 mL). We achieved 90.9% sensitivity and 72.7% specificity, 93% positive predictive value (PPV), 87.3% negative predictive value (NPV), and 87.3% accuracy in the differentiation of parathyroid lesions prior to post-processing. In a quantitative lesion analysis, our sensitivity increased up to 98%, specificity 80%, PPV 98%, and NPV 80% with an accuracy of 96.4%. Conclusions: CEUS of parathyroid lesions shows potential in the differentiation of adenoma from hyperplasia, regardless of the amount of contrast media injected. The quantitative analysis improved the sensitivity and specificity of differentiation between parathyroid lesions. Hyperplasia was characterized by homogeneous enhancement, fast uptake, and homogeneous wash-out appearance; adenoma—by peripheral uptake, central wash-out, and reduced hemodynamics. The use of CEUS quantification methods are advised to improve the ultrasound diagnostic role in suspected parathyroid lesions.

show abstract

“…In this context, the vascular pattern evaluation through Color Doppler US may be helpful for an appropriate differential diagnosis. Indeed, while PGs usually show polar feeding vessels, cervical lymph nodes characteristically present a hilar blood supply with feeding vessel entering the hilum centrally ( Figure 3 ) [ 67 ].…”

Section: Ultrasound Mimics Of Parathyroid Glandsmentioning

confidence: 99%

The Dark Side of Ultrasound Imaging in Parathyroid Disease

Centello

Sesti

Feola

et al. 2023

JCM

View full text Add to dashboard Cite

The diagnosis of parathyroid diseases by imaging still has some intrinsic technical limitations due to the differential diagnosis of different structures of the neck that mimic the parathyroid glands. In this view, ultrasound (US) is an established, low-cost, and non-invasive imaging technique that still represents the first-line approach for evaluating patients with parathyroid disease. The objective of this article is to provide a comprehensive review of the applications of USs in clinical practice, discussing the histopathological and US characteristics of the parathyroid glands in normal and pathological conditions, the advantages of preoperative imaging, and novel updates on the most useful and currently available multiparameter US techniques.

show abstract

Evaluation of B-Mode and Color Doppler Ultrasound in the Diagnosis of Malignant Cervical Lymphadenopathy

Abstract: Background B-mode ultrasound (BMUS) and color doppler ultrasound (CDUS) could be valuable in evaluating cervical lymphadenopathy compared to palpation. This study aimed at evaluating the efficacy of BMUS and CDUS in differentiating cervical lymph nodes into benign and malignant nature.

Cited by 8 publications

References 14 publications

Rapid progression of marginal zone B-cell lymphoma after COVID-19 vaccination (BNT162b2): A case report

Rapid progression of marginal zone B-cell lymphoma after COVID-19 vaccination (BNT162b2): A case report

Contrast-Enhanced Ultrasound Qualitative and Quantitative Characteristics of Parathyroid Gland Lesions

The Dark Side of Ultrasound Imaging in Parathyroid Disease

Contact Info

Product

Resources

About