Application of neck ultrasound in the diagnosis of sarcoidosis

Abstract Objective To explore the significance of neck ultrasound (NUS) combined with contrast-enhanced ultrasound (CEUS) in the diagnosis of sarcoidosis. Methods 88 patients with evidence of intrathoracic lymphadenopathy and suspected sarcoidosis with enlarged cervical lymph nodes underwent NUS, CEUS, fine-needle aspiration and core needle biopsy when technically feasible were retrospectively analyzed in this study. Seven characteristics such as enhanced mode (EM), resolution time, color Doppler flow imaging (CDFI), fading time, peaking state-uniformity, strengthen the area and symmetry were considered to perform the logistic regression model. Results Of 88 patients included in this study, sarcoidosis was accounted in 20 cases, tuberculosis in 23 cases, malignancy in 22 cases and inflammatory lymph node in 23 cases. There were statistically significant differences in symmetry, lymphatic hilum, homogeneity, CDFI pattern and elasticity score between the sarcoidosis and non-sarcoidosis groups via NUS. Similarly, we also acknowledged a statistically significant differences in EM, homogeneity, presence or absence of necrosis between the sarcoidosis and non-sarcoidosis groups via CEUS to further group the non-sarcoidosis into tuberculosis, malignancy or inflammatory disorder. The percentage correction of prediction was 90% (18/20). Conclusion NUS combined with CEUS has characteristic features in sarcoidosis with cervical lymph node involvement, which is helpful for its diagnosis and differential diagnosis. The binary classification model of NUS combined with CEUS features can help differentiate sarcoidosis from non-sarcoidosis groups.

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Application of Neck Ultrasound in the Diagnosis of Sarcoidosis

10.21203/rs.3.rs-692986/v1 ◽

2021 ◽

Author(s):

Mengjun Shen ◽

Ying Zhou ◽

Weiqing Gu ◽

Chengsheng Yin ◽

Yin Wang ◽

...

Keyword(s):

Lymph Node ◽

Binary Classification ◽

Color Doppler ◽

Needle Aspiration ◽

Lymph Node Involvement ◽

Classification Model ◽

Inflammatory Disorder ◽

Color Doppler Flow Imaging ◽

Cervical Lymph Nodes ◽

Neck Ultrasound

Abstract Objective: To explore the significance of neck ultrasound (NUS) combined with contrast-enhanced ultrasound (CEUS) in the diagnosis of sarcoidosis.Methods: 88 patients with evidence of intrathoracic lymphadenopathy and suspected sarcoidosis with enlarged cervical lymph nodes underwent NUS, CEUS, fine-needle aspiration (FNA) and core needle biopsy (CNB) when technically feasible were retrospectively analyzed in this study. Seven characteristics such as enhanced mode (EM), resolution time (RT), Color Doppler Flow Imaging (CDFI) , fading time (FT), peaking state-uniformity (PTSU), strengthen the area (STA) and symmetry were considered to perform the logistic regression model.Results: Of 88 patients included in this study, sarcoidosis was accounted in 20 cases, tuberculosis in 23 cases, malignancy in 22 cases and inflammatory lymph node in 23 cases. There were statistically significant differences in symmetry, lymphatic hilum, homogeneity, CDFI pattern and elasticity score between the sarcoidosis and non-sarcoidosis groups via NUS. Similarly, we also acknowledged a statistically significant differences in enhanced mode, homogeneity, presence or absence of necrosis between the sarcoidosis and non-sarcoidosis groups via CEUS to further group the non-sarcoidosis into tuberculosis, malignancy or inflammatory disorder. The percentage correction of prediction was 90% (18/20).Conclusion：NUS combined with CEUS has characteristic features in sarcoidosis with cervical lymph node involvement, which is helpful for its diagnosis and differential diagnosis. The binary classification model of NUS combined with CEUS features can help differentiate sarcoidosis from non-sarcoidosis groups.

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Are Papillary Microcarcinomas of the Thyroid Gland Revealed by Cervical Adenopathy More Aggressive?

The American Surgeon ◽

10.1177/000313481007600313 ◽

2010 ◽

Vol 76 (3) ◽

pp. 306-311 ◽

Cited By ~ 4

Author(s):

Bassam Abboud ◽

Ronald Daher ◽

Ghassan Sleilaty ◽

Gerard Abadjian ◽

Claude Ghorra

Keyword(s):

Lymph Node ◽

Total Thyroidectomy ◽

Excisional Biopsy ◽

Cervical Lymph Node Metastasis ◽

Needle Aspiration ◽

Lymph Node Involvement ◽

Clinicopathologic Features ◽

Papillary Thyroid ◽

Cervical Lymph Nodes

Therapeutic attitudes for papillary thyroid microcarcinoma (PTMC) range from observation alone to aggressive management. Clinicopathologic features, therapeutic options, and follow-up results are described in a series of PTMC revealed by cervical adenopathies. Twelve patients were enrolled in this retrospective study. They were all treated by total/near-total thyroidectomy with dissection of suspect cervical lymph nodes followed by radioactive iodine (RAI) and suppressive L-thyroxine therapies. Mean age at diagnosis was 32 years with a mean elapsed time to diagnosis of 45.3 months. Fine needle aspiration cytology and excisional biopsy of the lymph node led to a diagnosis in all cases. Cervical mass was ipsilateral to primary tumor in six patients (50%). Multifocality, bilaterality, and capsular invasion were encountered in 66.7, 66.7, and 41.7 per cent of patients, respectively. Lymph node involvement was bilateral in seven patients (58.3%) of whom thyroid foci were unilateral in two. No complications of thyroidectomy were encountered. At 60-month-follow up, no recurrence or metastasis was noted. PTMC revealed by cervical lymph node metastasis shows aggressive clinicopathologic features. They must be considered as papillary thyroid cancers and managed by total/near-total thyroidectomy with bilateral lymph node exploration followed by RAI therapy and suppressive L-thyroxine doses.

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A Study of FNAC of Cervical Lymph Nodes

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v7i1.2267 ◽

1970 ◽

Vol 7 (1) ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

G Shakya ◽

S Malla ◽

KN Shakya ◽

R Shrestha

Keyword(s):

Lymph Node ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Cervical Lymph Node ◽

Cervical Lymphadenopathy ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Cervical Lymph Nodes ◽

Fine Needle ◽

Needle Aspiration Cytology

Background: Fine Needle Aspiration Cytology (FNAC) is a reliable and least expensive method suitable for developing countries like Nepal for the investigation of lymphadenopathy. Knowledge about the pattern of lymphadenopathy is useful in pathological reporting as well as in many clinical settings with diagnostic dilemma. This is a baseline study to investigate the pattern of cervical lymphadenopathy by lymph node FNAC in Nepalese population. Methods: A retrospective study was conducted by critically analyzing the case reports on cervical lymph node FNAC from three years' records (July 2005 to June 2008) at the National Public Health Laboratory, Teku, Kathmandu. Review of all cytological reports were done according to standard guidelines and the diagnosis was classified and correlated with patients' age and ethnicity to explore the pattern and association. Results: Of 508 cervical lymph node FNAC cases, 50.4% was reactive non-specific, 22.4% was tubercular, 4.8 % malignant, 10% chronic granulomatous and the remaining was acute suppurative (12.4%). Highest incidence of malignancy was seen in the fifth decade (50%). Whereas, tubercular lymphadenopathy was found with increasing frequency through childhood (10.5%) and adolescence (21.7%) to young adulthood (30.4%), probably indicative of waning immunity of BCG vaccination. Ethnic groups comprising of Tamang, Sherpa and Bhote had the highest incidence of malignant as well as tubercular lymphadenopathy. Conclusion: The relationship of malignant and tubercular lymphadenopthy with age and ethnicity deserves further study. Efforts at preventing tubercular and early diagnosing malignant lymphadenopathy and reducing morbidity in general will find great usefulness in such associations. Key words: Cervical Lymphadenopathy, Fine Needle Aspiration Cytology, Pattern DOI: 10.3126/jnhrc.v7i1.2267 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 1-5

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Diagnosis of Tuberculous Lymphadenitis from Fine Needle Aspirate by PCR

Bangladesh Journal of Medical Microbiology ◽

10.3329/bjmm.v8i1.31051 ◽

2017 ◽

Vol 8 (1) ◽

pp. 2-6

Author(s):

Hasina Akhter ◽

Zakir Hossain Habib ◽

Imtiaz Ahmed ◽

Hafiza Akhter ◽

Abdullah Yusuf ◽

...

Keyword(s):

Lymph Node ◽

Predictive Value ◽

Needle Aspiration ◽

Lymph Node Involvement ◽

Tuberculous Lymphadenitis ◽

Fine Needle Aspirate ◽

Fine Needle ◽

Medical College ◽

Lymph Node Enlargement ◽

Node Involvement

Lymph node involvement is the commonest form of extra pulmonary tuberculosis (EPTB). This study was undertaken to evaluate the role of PCR using IS6110 as a target for Mycobacterium tuberculosis complex in the diagnosis of tuberculous lymphadenitis (TB-L) and was done in Microbiology department of Sir Salimullah Medical College from July 2009 to June 2010. Fine needle aspiration was performed on 107 patients with a clinical suspicion of tuberculous lymphadenitis from different hospitals of Dhaka City Corporation area. All the aspirated samples were subjected to culture and PCR for M.tuberculosis. Out of 107 patients with lymphadenopathy most of the patients (85.9%) had cervical lymph node enlargement followed by axillary groups (12.1%) and inguinal groups (1.9%). Out of 107 cases, 65 (60.7%) were PCR positive and 56 (52.3%) were culture positive. Among 51 (47.7%) culture negative cases 9 (17.65) were PCR positive. Sensitivity of PCR was 100% and specificity was 82.4%.The positive predictive value (PPV), negative predictive value (NPV) and accuracy of PCR were 86.2%, 100% and 91.6% respectively. PCR is the most sensitive in the detection of M.tuberculosis in fine needle aspirate and could be useful technique in establishing the diagnosis of tuberculous lymphadenitis.

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A case report of Rosai Dorfman disease

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20181890 ◽

2018 ◽

Vol 4 (3) ◽

pp. 868

Author(s):

Jyotika Waghray ◽

Pradyut Waghray

Keyword(s):

Lymph Node ◽

Plasma Cells ◽

Final Diagnosis ◽

Needle Aspiration ◽

Lymph Node Involvement ◽

Unknown Etiology ◽

Low Grade ◽

Massive Lymphadenopathy ◽

Rosai Dorfman Disease ◽

Node Involvement

<p>Rosai-Dorfman’s disease also known as sinus histiocytosis with massive lymphadenopathy (SHML) is characterized by distorted lymph node architecture with marked dilation of lymphatic sinuses occupied by numerous lymphocytes, as well as histiocytes with vesicular nucleus and abundant clear cytoplasm with phagocytized lymphocytes or plasma cells, also known as ‘emperipolesis’. This disease of unknown etiology progresses with a benign prognosis strictly and only when an early diagnosis and treatment is made. A late diagnosis and a generalized lymph node involvement contribute to a poor prognosis. We reported a case of a 29-year-old Indian female with a 4-month history of painful unilateral cervical mass and low-grade fever with the final diagnosis of Rosai-Dorfman disease. The final diagnosis was made by fine needle aspiration (FNA) biopsy of the cervical lymph node. In conclusion, FNA biopsy can be enough to make the diagnosis in most cases due to the distinct cytological features of SHML, thereby avoiding more invasive approaches that potentially are unnecessary.</p>

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Clinicopathological Study of Mucinous Carcinoma of Breast with Emphasis on Cytological Features: A Study at Tertiary Care Teaching Hospital of South India

Journal of Laboratory Physicians ◽

10.1055/s-0040-1714935 ◽

2020 ◽

Vol 12 (01) ◽

pp. 68-75

Author(s):

Panduranga Chikkannaiah ◽

Deinu Thangngeo ◽

Chanigaramaiah Guruprasad ◽

Srinivasamurthy Venkataramanappa

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Tertiary Care ◽

Mucinous Carcinoma ◽

Needle Aspiration ◽

Lymph Node Involvement ◽

Lymph Node Status ◽

Cytological Features ◽

The Mean ◽

Needle Aspiration Cytology

Abstract Introduction Mucinous carcinoma (MC) is a rare form of breast cancer. It accounts for 1 to 7% of the cases and characterized by the presence of extracellular mucin (ECM). Depending on the amount of mucin, it is classified into pure mucinous carcinoma (> 90%, PMC) and mixed mucinous carcinoma (MMC; < 90%). In comparison to most common subtypes, MC is having better prognosis. There exist clinicopathological differences among PMC and MMC and also MC and IDC-NOS. Materials and Methods MCs diagnosed between January 2012 and December 2017 were included. Fine needle aspiration cytology smears were screened for cellularity, ECM, nuclear pleomorphism, signet ring cells (SRC), mucinophages, and myxovascular fragments (MVF). Histopathology slides were screened to confirm the diagnosis. Immunohistochemistry slides were graded as per the standard protocol. Statistical analyses were performed by SPSS software. Results In the present study, MC constituted 3.3%. The mean age of the patients was 50.9 years. ECM, mucinophages, and SRC were the key diagnostic cytological features. The PMC and MMC were clinicopathologically distinct with respect to gross findings and lymph node status. MMCs were highly proliferative. The mean duration of follow-up was 24.5 months. Complications were more common in MMC than PMC. Lymph node involvement is the key prognostic factor and it is independent of other prognostic factors like age, size, and hormonal receptor status. Conclusion PMC are rare subtype of breast cancer. The diagnostic cytological features are ECM, MVF, and SRC. MMC and PMC are clinicopathologically and genetically distinct.

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Diagnostic yield of rapid on-site evaluation transbronchial needle aspiration versus conventional transbronchial needle aspiration: a single center experience

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2020.1144 ◽

2020 ◽

Vol 90 (1) ◽

Author(s):

Carmine Guarino ◽

Mariano Mollica ◽

Cristiano Cesaro ◽

Adriano Costigliola ◽

Maria Carolina Micheli ◽

...

Keyword(s):

Lymph Node ◽

Diagnostic Yield ◽

Mediastinal Lymph Node ◽

Diagnostic Testing ◽

Final Diagnosis ◽

Needle Aspiration ◽

Lymph Node Involvement ◽

Transbronchial Needle Aspiration ◽

Single Center Experience ◽

Site Evaluation

Trans-bronchial needle aspiration allows lymph node sampling in several thoracic conditions; the ability of Rapid On-Site Evaluation (ROSE) to predict the final diagnosis in this setting has not been well characterized. We performed a retrospective study to establish the utility of ROSE in the diagnosis of thoracic diseases with mediastinal lymph node involvement. We retrospectively reviewed 297 patients with hilar-mediastinal lymph node enlargement detected at CT scan from January 2013 to April 2016. 201 patients underwent conventional TBNA; in 96 patients, TBNA procedure was performed by on-site presence of a team of pathologists and research morphologists. Lung neoplasms, sarcoidosis, infections and lymphoma were the most common diseases diagnosed with TBNA samples. TBNA simultaneously performed in combination with ROSE produced an increase in percentage of appropriate samples compared to single cTBNA (adequate samples cTBNA vs ROSE-TBNA: 73% vs 81%; p<0.05). Our observations indicate an increase in adequacy of fine needle aspirations and increased diagnostic yield in the ROSE group. In conclusions, ROSE may serve to reduce procedure time and enhance sample triaging therefore limiting the need for further invasive diagnostic testing.

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Extramedullary Plasmacytoma of the Tonsil with Nodal Involvement

International Journal of Otolaryngology ◽

10.1155/2010/302656 ◽

2010 ◽

Vol 2010 ◽

pp. 1-3 ◽

Cited By ~ 4

Author(s):

Simon Bazaadut ◽

Dilshard Soodin ◽

Pradeep Singh ◽

Alhossain Khalafallah ◽

Shannon Withers ◽

...

Keyword(s):

Lymph Node ◽

Adjuvant Radiotherapy ◽

Needle Aspiration ◽

Lymph Node Involvement ◽

Extramedullary Plasmacytoma ◽

Nodal Involvement ◽

Careful Planning ◽

Fine Needle ◽

Fine Needle Aspirates ◽

Node Involvement

We present a rare case of extramedullary plasmacytoma of the palatine tonsil with cervical lymph node involvement treated by surgical resection. A 58-year-old Caucasian male presented with a solitary 3 cm×3 cm jugulodigastric lymph node and was found to have an ipsilateral tonsillar swelling. The involved tonsil and lymph node were surgically resected after two inconclusive fine-needle aspirates, and plasmacytoma was confirmed histologically and by immunocytochemistry. Adjuvant radiotherapy was not indicated as adequate resection was achieved at surgery. We also highlight the challenges of diagnosis when fine-needle aspiration is inconclusive and the need for careful planning before surgery.

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