• This axilla ultrasound shows a case of severe eccentric compression and displacement of the hilum to the edge of the node:
    • Favoring metastatic disease:
      • Biopsy of the node provides pathology staging:
        • Which may influence treatment options
  • Typical lymph node ultrasound appearances include:
    • Uniformly mildly thickened cortex:
      • Typical of inflamed or reactive lymph node
    • Eccentric cortical thickening:
      • Favors metastatic disease
Severe eccentric compression and displacement of the mediastinum to the edge of the node
  • Convex indentations of the hilum:
    • Favors metastatic diseased
  • Severe compression of the hilum to slit-like configuration:
    • Can occur in metastatic or severely inflamed lymph node
  • Severe eccentric compression and displacement of the hilum to the edge of the node:
    • Favors metastatic disease
  • Complete obliteration of the hilum and rounding of the node:
    • Favors metastatic disease (can also occur in severe necrotizing lymphadenitis)
  • Perinodal invasion by metastasis:
    • The outer thin echogenic capsule cannot be identified
    • Angular margins
  • References
    • Stavros AT. Evaluation of regional lymph nodes in breast cancer patients. In: Stavros AT. Breast Ultrasound. Philadelphia, PA: Lippincott Williams & Wilkins; 2004:858-859.
    • AIUM curriculum for fundamentals of ultrasound physics and instrumentation. JUltrasound Med 2019;38(8):1933-1935. https://onlinelibrary.wiley.com/doi/epdf/10.1002/jum.15088. Accessed July 16, 2020.
#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #Surgeon #Doctor #BreastCancer #MountSinaiMedicalCenter #Mexico #Miami

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