Ultrasound Appearance of Axillary Lymph Nodes

Rodrigo Arrangoiz MS, MD, FACS, FSSO
Abnormal lymph node with eccentric cortical thickening
  • This axilla ultrasound shows a case of severe eccentric compression and displacement of the hilum to the edge of the node:
    • Favoring metastatic disease
  • Typical lymph node ultrasound appearances include:
    • Uniformly mildly thickened cortex
      • Typical of inflamed or reactive lymph node
    • Eccentric cortical thickening:
      • Favors metastatic disease (Image)
    • Convex indentations of the hilum:
      • Favors metastatic disease
    • 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:
      • Favoring metastatic disease
    • Complete obliteration of the hilum and rounding of the node:
      • Favoring metastatic disease:
        • Can also occur in severe necrotizing lymphadenitis
    • Perinodal invasion by metastasis:
      • The outer thin echogenic capsule cannot be identified:
        • Angular margins
Severe eccentric compression and displacement of the hilum to the edge of the node.
  • 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 #Doctor #Surgeon #CancerSurgeon #SurgicalOncologist #Breast Surgeon #MountSinaiMedicalCenter #MSMC #Miami #Mexico #BreastCancer
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Published by Rodrigo Arrangoiz MS, MD, FACS, FSSO

My name is Rodrigo Arrangoiz I am a breast surgeon/ thyroid surgeon / parathyroid surgeon / head and neck surgeon / surgical oncologist that works at Center for Advanced Surgical Oncology in Miami, Florida. I was trained as a surgeon at Michigan State University from (2005 to 2010) where I was a chief resident in 2010. My surgical oncology and head and neck training was performed at the Fox Chase Cancer Center in Philadelphia from 2010 to 2012. At the same time I underwent a masters in science (Clinical research for health professionals) at the University of Drexel. Through the International Federation of Head and Neck Societies / Memorial Sloan Kettering Cancer Center I performed a two year head and neck surgery and oncology / endocrine fellowship that ended in 2016. Mi nombre es Rodrigo Arrangoiz, soy cirujano oncólogo / cirujano de tumores de cabeza y cuello / cirujano endocrino que trabaja Center for Advanced Surgical Oncology en Miami, Florida. Fui entrenado como cirujano en Michigan State University (2005 a 2010 ) donde fui jefe de residentes en 2010. Mi formación en oncología quirúrgica y e n tumores de cabeza y cuello se realizó en el Fox Chase Cancer Center en Filadelfia de 2010 a 2012. Al mismo tiempo, me sometí a una maestría en ciencias (investigación clínica para profesionales de la salud) en la Universidad de Drexel. A través de la Federación Internacional de Sociedades de Cabeza y Cuello / Memorial Sloan Kettering Cancer Center realicé una sub especialidad en cirugía de cabeza y cuello / cirugia endocrina de dos años que terminó en 2016.

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