Lymph node metastasis on contrast enhanced ultrasound

Case contributed by Dr Teresa Fontanilla

Presentation

35 yo caucasian female presents with cervical node swelling. No relevant diseases in her medical history.

Patient Data

Age: 35
Gender: Female
Ultrasound

B MODE; COLOR AND POWER DOPPLER AND CEUS OF CERVICAL NODE

B mode cervical ultrasound shows lymph node with displaced hilum and nodular thickenning of the cortex, suggesting metastatic involvement. Other enlarged cervical nodes were seen (not shown)

Case Discussion

Clinically the patient was suspect of inflammatory cervical node enlargement according to her age and lack of a relevant history. Cervical nodes were worrisome in  B-mode US, with nodular thickening of the cortex, displaced hilum and displaced hilar vessels on colour Doppler US. CEUS finding of nodular almost non-enhancing areas made the possibility of metastatic involvement seem very probable. Fine -needle aspiration of the node and CT scan showed metastatic lung adenocarcinoma.

Please compare these findings with those of a inflammatory node, in which CEUS show homogeneous enhancement:

http://radiopaedia.org/cases/inflammatory-lymph-node-doppler-and-ceus

 

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Case information

rID: 34759
Case created: 8th Mar 2015
Last edited: 7th Dec 2015
System: Head & Neck
Tag: ceus
Inclusion in quiz mode: Included

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