Normal and pathological axillary lymph nodes

Case contributed by Dr Gerard Carbo

Normal and pathologic axillary lymph nodes characteristics.

Case Discussion

FEATURES OF NORMAL AXILLARY LYMPH NODES

  • Normal LN should be oval and have a smooth well-defined margin. The cortex should be slightly hypoechoic on US and uniformly thin, measuring 3 mm or less.
     

FEATURES SUGGESTING METASTATIC AXILLARY LYMPH NODES

  • Cortical thickening (> 3 mm) with or without focal bulges (especially asymmetrical, irregular or inhomogeneous)
  • Complete or partial loss or disruption of central fatty hilum
  • Complete or partial replacement of LN with an ill-defined or irregular mass
  • Rounded morphology or irregular margins
  • Short axis greater than long axis 
  • Presence of abnormal color Doppler flow
  • Microcalcifications may be seen similar to the primary tumor
  • Perifocal edema on MRI (↑ T2 in the surrounding fat)
  • Lymph node with indistinct or spiculated margins and perinodal fatty infiltration suggest extranodal extension (poor prognosis)

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.