logo Ultrasound Cases
powered by FUJIFILM Healthcare Europe and SonoSkills

August 2019

Three patients with abnormal lymph nodes. Which ones would you refer for a biopsy and which one not?
Bookmark

Clinical information

Three patients with palpable lymph nodes in the axilla groin and neck examined for SONOZORG a primary care ultrasound facility. Which patients would you biopsy and which one not?

Ultrasound Images & Clips

Three patients with abnormal lymph nodes

Three patients two adults and one boy with abnormal lymph nodes. Which ones would you refer for a biopsy and which one not
Three patients two adults and one boy with abnormal lymph nodes. Which ones would you refer for a biopsy and which one not
The first patient was an adult with a large axillary lymph node
The first patient was an adult with a large axillary lymph node
The node is oval but without a hilum
The node is oval but without a hilum
The node is vascularized with multiple peripheral vessels
The node is vascularized with multiple peripheral vessels
There are other but smaller and round lymph nodes
There are other but smaller and round lymph nodes
There are other but smaller and round lymph nodes
There are other but smaller and round lymph nodes
Last image of the two nodes together
Last image of the two nodes together
The second patient is also an adult with a large round node in the groin
The second patient is also an adult with a large round node in the groin
The node is vascularized
The node is vascularized
And there are smaller round nodes. We also decided to refer this patient for biopsy and this too proved to be a T cell lymphoma
And there are smaller round nodes. We also decided to refer this patient for biopsy and this too proved to be a T cell lymphoma
The third patient is a child with lymph nodes in the neck
The third patient is a child with lymph nodes in the neck
The node was oval
The node was oval
There were other oval but small nodes
There were other oval but small nodes
The nodes are vascularized from one hilum. Because we thought the node could be reactive we decided not to refer the patient but wait and check again to see if the nodes changed over time. After a month the nodes returned to normal.
The nodes are vascularized from one hilum. Because we thought the node could be reactive we decided not to refer the patient but wait and check again to see if the nodes changed over time. After a month the nodes returned to normal.

Conclusion

The first two patients proved to have a T cell lymphoma. Beware of round nodes, nodes without or a compressed hilum and multiple vessel poles. The third patient was a child with benign reactive lymph.

Created with

  • Fujifilm Ultrasound System
Browse through our ultrasound product portfolio
Looking for MSK Ultrasound Education? Visit Sonoskills.com
photo Taco Geertsma
Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

More Cases from Taco Geertsma