Key points of ultrasound differentiation of benign and malignant superficial lymph nodes

Superficial lymph nodes are an important part of the human immune system, and their lesions often manifest as enlargement. Benign lymph node lesions are usually caused by inflammation or reactive hyperplasia, while malignant lymph node lesions may be caused by malignant diseases such as tumor metastasis or lymphoma. Therefore, the differentiation of benign and malignant superficial lymph node lesions is of great clinical significance. Ultrasound, as a non-invasive, simple and economical examination method, has important application value in the diagnosis and differential diagnosis of superficial lymph node lesions.

1. Ultrasound appearance of benign superficial lymph nodes

1. Regular morphology: Benign lymph nodes are usually oval or kidney-shaped, with the long axis parallel to the skin, clear boundaries, and intact capsule.

2. Uniform internal echo: The internal echo of benign lymph nodes is uniform, with clear boundaries between the cortex and medulla, the cortex is low echoic, and the medulla is high echoic.

3. Normal blood flow signals: The blood flow signals inside and around benign lymph nodes are normal, distributed in a tree-like or dot-like manner.

4. No calcification: Benign lymph nodes usually have no calcification.

5. Normal size: Benign lymph nodes are usually normal in size, with the long diameter generally not exceeding 1 cm.

2. Ultrasound manifestations of malignant superficial lymph nodes

1. Irregular morphology: Malignant lymph nodes have irregular shapes, unclear boundaries, and incomplete or disappeared capsules.

2. Uneven internal echoes: The internal echoes of malignant lymph nodes are uneven, the boundary between the cortex and medulla is unclear, the cortex is thickened, the medulla is thinned or disappears, and manifestations such as liquefaction and necrosis may occur.

3. Abnormal blood flow signals: The blood flow signals inside and around malignant lymph nodes are abnormally rich and chaotically distributed, and an arterial spectrum may appear.

4. Calcification: Malignant lymph nodes may show calcification, which appears as dots, patches or masses with strong echoes.

5. Abnormal size: Malignant lymph nodes are usually abnormally enlarged, with the long diameter generally exceeding 1 cm and even reaching several centimeters.

3. Key points of ultrasound differentiation of benign and malignant superficial lymph nodes

The key points of ultrasonic differentiation of benign and malignant superficial lymph nodes mainly include morphological regularity, internal echo uniformity, blood flow signal, calcification, size, aspect ratio, cortical thickness, medullary condition, etc. In actual operation, these key points should be used in combination for comprehensive judgment to improve the accuracy of diagnosis and provide a reliable basis for clinical treatment.

1. Morphological regularity: Benign lymph nodes have regular shapes, while malignant lymph nodes have irregular shapes. Therefore, during ultrasound examination, attention should be paid to whether the shape of the lymph nodes is regular.

2. Internal echo uniformity: The internal echo of benign lymph nodes is uniform, while the internal echo of malignant lymph nodes is uneven. Therefore, during ultrasound examination, attention should be paid to observing whether the internal echo of the lymph nodes is uniform.

3. Blood flow signal: The blood flow signal of benign lymph nodes is normal, while the blood flow signal of malignant lymph nodes is abnormally rich. Therefore, during ultrasound examination, attention should be paid to observing the blood flow signal of lymph nodes.

4. Calcification: Benign lymph nodes usually do not show calcification, while malignant lymph nodes may show calcification. Therefore, during ultrasound examination, attention should be paid to whether the lymph nodes are calcified.

5. Size: Benign lymph nodes are usually normal in size, while malignant lymph nodes are usually abnormally enlarged. Therefore, it is important to measure the size of lymph nodes during ultrasound examinations.

6. Aspect ratio: The aspect ratio of benign lymph nodes is generally less than 1, while the aspect ratio of malignant lymph nodes is generally greater than 1. Therefore, attention should be paid to measuring the aspect ratio of lymph nodes during ultrasound examination.

7. Cortical thickness: The cortical thickness of benign lymph nodes is generally normal or slightly thickened, while the cortical thickness of malignant lymph nodes is significantly thickened. Therefore, changes in cortical thickness should be carefully observed during ultrasound examination.

8. Medullary condition: The medulla of benign lymph nodes is generally clearly visible, while the medulla of malignant lymph nodes may become thinner, disappear, or show liquefaction, necrosis, etc. Therefore, the condition of the medulla should be carefully observed during ultrasound examination.

9. Infiltration of surrounding tissues: Benign lymph nodes generally do not infiltrate surrounding tissues, while malignant lymph nodes may infiltrate surrounding tissues or show adhesions, etc. Therefore, attention should be paid to observing the surrounding tissues during ultrasound examination.