Normal and pathologic axillary lymph nodes characteristics.
Author: Gerard Carbo
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 colour Doppler flow
microcalcifications may be seen similar to the primary tumour
perifocal oedema on MRI (↑T2 signal in the surrounding fat)
lymph node with indistinct or spiculated margins and perinodal fatty infiltration suggest extranodal extension (poor prognosis)
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