August 2019

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

Clinical Info

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. We decided to refer the patient for biopsy because we thought the nodes were suspicious for malignancy. It prove to be a T cell lymphoma
Last image of the two nodes together. We decided to refer the patient for biopsy because we thought the nodes were suspicious for malignancy. It prove to be a T cell lymphoma
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. Children often have reactive lymph nodes. After a month the 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. Children often have reactive lymph nodes. After a month the nodes

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

  • Hitachi Ultrasound System