Sonographic evaluation of the cervical lymphadenopathy with pathological correlation

Abstract

 Background: Enlarged cervical nodes are very common presentation in radiology department. The accurate diagnosis of the cervical lymphadenopathy is very crucial for further management. The aim of this study was to evaluate the cervical lymphadenopathy by sonography and see the effec­tiveness of B mode ultrasound and color Doppler ultrasound in differentiation between the benign and malignant lymph nodes.

Methods: A retrospective study was conducted in the Department of Radiology, College of Medical sci­ences, Bharatpur from 2019 to 2021 among 40 patients with clinically palpable cervical nodes. The so­nographic findings and FNAC/biopsy correlation were done with calculation of the p value, sensitivity, specificity, positive and negative predictive values. SPSS 20.0 and Microsoft Excel were used for the data analysis and presentation.

Results: Among 40 patients the most common diagnosis was tuberculosis nodes followed by reactive nodes, metastatic nodes and lymphomatous nodes. The sensitivity and specificity for reactive nodes is very high 92% and 89% respectively for B-mode and for color Doppler ultrasound it is 82% and 90%. For TB nodes and metastatic nodes B-mode and color Doppler ultrasound has low sensitivity and high specificity 72% and 71% sensitivity for TB and metastatic nodes respectively and 91% and 94% specificity for TB and metastatic nodes respectively.

Conclusions: B mode and color Doppler sonography is very helpful to accurately diagnose the cause of cervical lymphadenopathy with high specificity and sensitivity. However, the differentiation between the tubercular, metastatic and lymphomatous nodes by sonography is very difficult and requires FNAC/biopsy correlation.