Diagnosis Sonographic signs
Inflamed lymph nodes (p. 110) Variable size, L/W ratio j 2, prominent echogenic hilum
Lymph node metastases (p. 112) Variable size, L/W ratio < 2, absent hilar sign, aberrant vessels
Malignant lymphoma (p. 113) Variable size, L/W ratio often < 2, absent hilar sign, variable pattern of involvement, variable echogenicity, increased vascularity on CDS
|8© (T) Porta hepatis Visceral
© Splenic hilum lymph nodes
(4) Superior and inferior mesenteric group © Para-aortic group 0 Parietal ©Iliac group lymph nodes
Fig. 143 Localization: abdominal lymph node groups
Fig. 145a, b Echogenicity. a Enlarged lymph node with an echogenic hilum and hypoechoic cortical parenchyma. b The hilar vessels course within the echogenic hilum
o n Causes: Table 18 reviews the most frequent causes of enlarged lymph nodes. Ultrasound examination contributes significantly to benign-malignant differentiation.
Table 18 ■ Most frequent
Inflamed lymph nodes
Mesenteric lymphadenitis Ileitis
Appendicitis Diverticulitis Hepatitis Cholecystitis, etc.
causes of enlarged lymph nodes Metastatic lymph nodes Malignant lymphoma
ENT carcinoma Bronchial carcinoma Thyroid carcinoma Breast carcinoma Esophageal carcinoma Gastric carcinoma Gallbladder carcinoma Colon carcinoma Malignant melanoma Sarcoma, etc.
Low-grade NHL High-grade NHL Hodgkin disease
n Most frequent causes: see Table 18.
n Clinical manifestations: The clinical findings often suggest the correct diagnosis (local infection with regional lymphadenopathy) and may include inflammatory signs, tenderness to palpation, and positive serology. n Sonographic diagnosis: The sonographic criteria for benign-malignant differentiation are helpful in the evaluation of peripheral lymphadenopathy (Figs. 144 and 145).
• Prominent echogenic hilum; occasional concentric or eccentric cortical widening
• Frequent visualization of hilar vessels or a branched vascular pattern n Sonographic findings: See Figs. 146-149.
n Sonographic findings: See Figs. 146-149.
Ifl c lo
Fig. 147 Solitary hypoechoic lymph node (L) at the porta hepatis in infectious hepatitis. HA = hepatic artery, SA = splenic artery, CT = celiac trunk
Fig. 149 Small lymph nodes (arrows) produce a speckled echo texture in the mesentery of a patient with gastroenteritis. VC = vena cava, AO = aorta
Was this article helpful?
All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.