ULTRASONOGRAPHY AS A DIAGNOSTIC TOOL TO DIFFERENTIATE CANCEROUS AND NON CANCEROUS CERVICAL LYMPHADENOPATHY IN WEST BENGAL POPULATION

Abstract

Background:  Cervical lymph nodes are often affected by a wide range of medical conditions. Thyroid cancer, distant
metastases, and tuberculosis are the three most common causes of cervical lymphadenopathy.

Objective: To assess the role of ultrasound in the differential diagnosis of cervical lymphadenopathy.
Methods: The cervical lymph nodes were imaged using a real-time linear scanner with a 7.5- or 11-MHz probe.
Retrospective analysis of ultrasonography results was done for the lymph nodes of 432 patients. When required, FNAC,
CECT neck, MRI, and core needle biopsy were used to reassess the USG results.
Results: Of the 432 lymph nodes, 108 had tuberculosis-related lymphadenitis, 46 had metastasized lymph nodes, 59 had
lymphomas, 114 had inflammatory lymph nodes, and 105 had normal lymph nodes. Greater ultrasonography features
were found in lymphomatous, metastatic, and tubercular lymph nodes. There was a noticeable hypoechoic center in both
the tubercular and metastatic types. A lymph node excision biopsy was carried out to confirm the diagnosis because the
FNAC result was uncertain in most of the individuals. To diagnose lymphadenitis, 100% specificity and 100% sensitivity
were employed.

Conclusion: According to ultrasonography criteria like round form, absence of hilar echo, sharp nodal boundaries,
hypoechoic internal echogenicity, and presence of intranodal necrosis, the cervical group of lymph nodes had a high
likelihood of developing into metastatic cervical lymph nodes. When combined with other radiographic and histological
features, ultrasonography can be a very helpful technique for identifying high-risk diseases early on.