From the case:
Normal and pathological axillary lymph nodes
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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)
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