Cervical lymphadenopathy: ratio of long- to short-axis diameter as a predictor of malignancy.

The purpose of this study was to evaluate short- and long-axis diameters of enlarged cervical lymph nodes with ultrasonography and to determine whether the long-to-short axis (l/s) ratio is a valid diagnostic parameter in the differentiation between benign and malignant nodal disease. 730 enlarged cervical lymph nodes in 285 patients were examined with ultrasound. The short- and the long-axis diameters of each enlarged node were measured and the l/s ratio calculated. Definite diagnoses of the nodes were obtained by histological examination following neck dissection. 95% of enlarged cervical nodes shown on ultrasound to have a l/s ratio of more than 2 were correctly diagnosed as benign. Nodes presenting with a more circular shape and a l/s ratio of less than 2 were diagnosed correctly as metastases with 95% accuracy. The l/s ratio of lymph nodes thus provides an excellent criterion for differentiation between benign and malignant enlargement in cervical lymphadenopathy.

[1]  F. Karnel,et al.  Sonographische Halsanatomie und ihre Bedeutung beim Lymphknotenstaging von Kopf-Hals-Malignomen , 1987 .

[2]  E. Salomonowitz,et al.  Lymph nodes of the neck: evaluation with US. , 1986, Radiology.

[3]  W. Hanafee,et al.  CT of cervical lymph node cancer. , 1981, AJR. American journal of roentgenology.

[4]  P. Som,et al.  Lymph nodes of the neck. , 1987, Radiology.

[5]  R. Bleier,et al.  [Cervical lymph node metastases: a histologically controlled comparison of palpation, sonography and computed tomography]. , 1990, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[6]  A. Feller,et al.  [The diagnostic assessment of enlarged lymph nodes by the qualitative and semiquantitative evaluation of lymph node perfusion with color-coded duplex sonography]. , 1991, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[7]  K. Wernecke,et al.  Differentiation of benign from malignant superficial lymphadenopathy: the role of high-resolution US. , 1992, Radiology.

[8]  M. Friedman.  Metastatic neck disease. , 1988, Archives of otolaryngology--head & neck surgery.

[9]  W. Hruby,et al.  [Laryngeal and hypopharyngeal carcinoma--the limits and advantages of sonography]. , 1989, RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin.

[10]  L. North,et al.  Lymphomas of the head and neck: CT findings at initial presentation. , 1987, AJR. American journal of roentgenology.

[11]  D. Leopold,et al.  Benign osteoblastoma. Report of a case and review of the literature. , 1984, Archives of otolaryngology.

[12]  O. Beahrs.  Surgical anatomy and technique of radical neck dissection. , 1977, The Surgical clinics of North America.

[13]  F Demard,et al.  Ear, nose, and throat cancer: ultrasound diagnosis of metastasis to cervical lymph nodes. , 1984, Radiology.

[14]  K. Vosteen,et al.  Der Einfluß von Tumorgröße, Lymphknotenbefall und Behandlungsart auf die Prognose des Hypopharynxkarzinoms , 1982 .

[15]  C. Balu-Maestro,et al.  Lymphomatous superficial lymph nodes: US detection. , 1987, Radiology.

[16]  H. Glanz,et al.  Histologisch kontrollierter Vergleich von Palpation und Sonographie bei der Diagnose von Halslymphknotenmetastasen , 1987 .