The use of the ultrasound for otorhinolaryngology, head and neck diseases (literature review)

Despite the fact that otorhinolaryngologists are already very busy finding a solution to the problem of chronic tonsillitis, it remains unresolved. The prevalence of chronic tonsillitis does not decrease, but rather increases. Diseases of the tonsils are characteristic primarily of the child and adult working population. Chronic tonsillitis attracts attention not only as an independent disease, but as a cause of frequent local and especially systemic complications, which number more than 100. All these facts speak about the unresolved and urgency of the problem of chronic tonsil disease. In the diagnosis of neck diseases, one of the most common methods is ultrasound. It has a number of significant advantages over other methods, such as high sensitivity and specificity, the ability to detect minor changes in the organs, non-invasiveness of the study, painlessness, accessibility, and the absence of ionizing radiation. The aim of the literature review is to identify, analyze, and systematize literature data on the application of the ultrasonic research method in neck organ pathology. Ultrasound diagnostics in the neck is widely used and is actively studied in acute inflammatory-purulent pathology (paratonsillar abscesses, phlegmon), in the pathology of the larynx and trachea, salivary and thyroid glands, as well as in the metastasis of malignant neoplasms to the lymph nodes. There are several methods for diagnosing lymph nodes, such as: puncture and excision biopsy, lymphography, scintigraphy, thermography and ultrasound ultrasound. Despite such a variety of diagnostic methods, ultrasound is the method of choice for imaging cervical lymph nodes. One of the most modern methods in ultrasound diagnostics is elastography. This method is most informative in cases when changes in tissues are small in size and cannot be detected using standard ultrasound modes.

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Rare Presentation of Self-Limiting Kikuchi–Fujimoto Disease in Relapsing Nature

Case Reports in Medicine ◽

10.1155/2020/9785104 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Karo Servatyari ◽

Hero Yazdanpanah ◽

Chamara Dalugama

Keyword(s):

Lymph Nodes ◽

Wide Spectrum ◽

Clinical Manifestations ◽

Cervical Lymphadenopathy ◽

Excision Biopsy ◽

Presentation Of Self ◽

Rare Presentation ◽

Cervical Lymph Nodes ◽

One Year ◽

Loss Of Appetite

Background. Kikuchi–Fujimoto disease (KFD) is a rare, benign, and self-limiting disease that is commonly associated with cervical lymphadenopathy and fever. The disease has a wide spectrum of clinical manifestations, and definitive diagnosis is based on the histological appearance in the excision biopsy of the lymph nodes. Recurrence of KFD is reported rarely. Case Presentation. A 56-year-old Iranian woman with a background history of thrombocytopenia presented with fever, malaise, loss of appetite, and weight loss with cervical lymphadenopathy. The excision biopsy of the cervical lymph nodes confirmed the diagnosis of KFD, and she made a full recovery with improvement of symptoms, regression of cervical lymph nodes, and normalization inflammatory markers. One year after remission, she presented with similar clinico-biochemical profile, and repeat biopsy confirmed KFD. Conclusion. Although the rate of recurrence of the disease is very low, the treating physician should consider the possibility and confirm it histologically.

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UTILITY OF ULTRASONOGRAPHY DIAGNOSIS FOR CERVICAL LYMPHADENOPATHY IN CENTRAL INDIAN POPULATION- A HOSPITAL BASED OBSERVATIONAL STUDY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i5.252 ◽

2019 ◽

Vol 3 (5) ◽

Author(s):

Dr. Neerja Jain Sudhakar ◽

Dr. C. Sudhakar ◽

Dr. Priyadershini Rangari

Keyword(s):

Lymph Nodes ◽

Indian Population ◽

Cervical Lymphadenopathy ◽

Excision Biopsy ◽

Tuberculous Lymphadenitis ◽

Metastatic Node ◽

Cervical Lymph Nodes ◽

Round Shape ◽

Time Linear ◽

Keywords Ultrasonography

Background: Cervical lymph nodes are frequently involved in a number of disease conditions. The most commonly seen causes of cervical lymphadenopathy are tuberculosis, distant metastasis and lymphoma. Objective: To assess the usefulness of ultrasonography in the differential diagnosis of cervical lymphadenopathy. Methods: ultrasonography of cervical lymph nodes was performed with a real-time linear scanner using a 7.5- or 11-MHz probe. Ultrasonography findings were retrospectively reviewed in 432 lymphnodes of 120 patients. USG findings were reevaluated by FNAC, CECT neck, MRI and core needle biopsy wherever required. Results: out of 432 lymphnodes; 108 tuberculous lymphadenitis, 46 metastatic, 59 lymphoma, 114 inflammatory and 105 normal lymph nodes were observed. Ultrasonography features were found to be stronger in tubercular, metastatic and lymphomatous lymphnodes. Hypoechoic center was prominently observed in tubercular and metastatic form. In most of the patients, FNAC result was equivocal and a subsequent excision biopsy of the lymph node was carried out to confirm the diagnosis. Lymphadenitis was diagnosed with a sensitivity of 100% and a specificity of 100%. Conclusion: This study concluded that cervical group of lymph nodes with ultrasonography features such as round shape, absence of hilar echo, sharp nodal borders, Hypoechoic internal echogenicity and presence of intranodal necrosis were highly suggestive of metastatic cervical lymph nodes. Ultrasonography along with other radiological and histopathological parameters can be very effective in early diagnosis of high risk diseases. Keywords: Ultrasonography; Tuberculous Lymphadenitis; Malignant Lymphoma; Metastatic Node

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Diagnosis and treatment of infants with severe hydronephrosis (literature review)

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ◽

10.17816/psaic681 ◽

2020 ◽

Vol 10 (3) ◽

pp. 339-352

Author(s):

Svetlana V. Sergeeva

Keyword(s):

Surgical Treatment ◽

Literature Review ◽

Functional State ◽

Classification Systems ◽

Renal Parenchyma ◽

Diagnostic Methods ◽

Publication Date ◽

Postnatal Management ◽

Pelvic Wall ◽

Ultrasound Diagnostics

Introduction. An assessment of the effectiveness of antenatal diagnosis and postnatal management of infants and infants with grade IV hydronephrosis was performed based on the analysis of domestic and foreign literature. Literature review. In the literature analysis, we used the databases СlinicalKey, Web of Science, Cyberleninka, PubMed, and Medline. The search was not limited by the publication date; instead, the searchs emphasis was placed on publications of the last 10 years. Classification. Several classification systems have been developed to assess the severity of hydronephrosis in infants. However, none of them describes the degree of expansion of the PCS and the functional state of the renal parenchyma. This work shows the stages of embryogenesis of the obstruction of the pyelourethral segment. Diagnosis. The issues of antenatal diagnostics and prognostically significant outcome criteria for an intrauterine malformation of the fetal urinary system are considered. The main diagnostic methods in the postnatal period are described. Morphological changes. Variants of pathomorphological changes in the renal parenchyma, the pelvic wall, and ureter in prolonged obstruction conditions are described. The role and variability of the number of Cajal interstitial cells in the pelvic wall and ureter in hydronephrosis have been analyzed. Treatment. Particular attention is paid to nephroprotective therapy and surgical treatment tactics of the defect. Questions regarding the timing and choice of treatment methods, the need and duration of preliminary urine diversion in infants and children with grade IV hydronephrosis remain open. Conclusion. Analysis of the world literature shows that there is no single protocol for intrauterine diagnosis and postnatal management of children with grade IV hydronephrosis. The functional state of the parenchyma is possible only with a comprehensive examination to assess the degree of hydronephrosis. Improving antenatal and postnatal diagnostics, therapeutic and surgical treatment of children with severe hydronephrosis should be based on a doctors cooperation, a specialist in ultrasound diagnostics, a nephrologist, and a pediatric surgeon.

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Thyroglobulin measurement in fine-needle aspirates of lymph nodes in patients with differentiated thyroid cancer

Endocrine Surgery ◽

10.14341/serg9824 ◽

2019 ◽

Vol 13 (1) ◽

pp. 17-25

Author(s):

Zamira T. Zuraeva ◽

Larisa V. Nikankina ◽

Galina S. Kolesnikova ◽

Fatima M. Abdulhabirova ◽

Pavel O. Rumiantsev ◽

...

Keyword(s):

Lymph Nodes ◽

Prognostic Significance ◽

Diagnostic Methods ◽

Automated System ◽

Youden Index ◽

Serum Thyroglobulin ◽

Cervical Lymph Nodes ◽

Fine Needle ◽

Lymph Nodes Metastasis ◽

Diagnostic Threshold

Background: The high incidence of cervical lymph nodes metastasis in highly differentiated thyroid carcinoma (DTC) and insufficient of existing diagnostic methods determines the urgency of finding reliable and more effective tests. Aims: The aim of our study is to determine the prognostic significance of the thyroglobulin measurement in washout fluid from fine-needle aspiration biopsy (FNA-Tg) and the cut-off value in the diagnosis of DTC lymph nodes metastasis. Materials and methods: 245 patients evaluated for suspicious cervical lymph nodes were retrospectively reviewed. All patients underwent FNA-Tg, serum thyroglobulin (sTg) levels, thyroglobulin antibodies (Tg-Ab), thyroid-stimulating hormone (TSH) were measured. 125 patients with malignant changes according to FNA and/or high FNA-Tgvalues underwent surgical treatment. Patients were divided into 2 groups with reactive (n = 23) and metastatic (n = 102) changes. FNA-TG was assayed on automated system Cobas 601 (Roche, France). Results: All patients were comparable by sex, age and levels of TSH, sTG, Tg-Ab. The FNA-Tg median in metastatic group was 537.0 [0.1; 1000], and in benign group – 17.9 [0.5; 158.0], p = 0.003. The sensitivity of isolated FNA was 85%, specificity 57%, AUC = 0.618, 95% CI 0.516–0.713. The sensitivity and specificity of FNA-Tg was 73% and 100%, respectively, AUC = 0.865, 95% CI 0.78–0.92. The optimal cut-off point for malignancy was >9.2 ng/ml (sensitivity 75%, specificity 100%), Youden Index 0.73. Conclusions: Additional FNA-Tg may increase the sensitivity of isolated FNA in evaluation of DTC lymph node metastasis. The optimized cut-off value >9.2 ng/ml can be proposed as a diagnostic threshold for the definition of malignancy.

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Kikuchi Disease in Korean Children: Clinical Features and Disease Courses.

Blood ◽

10.1182/blood.v110.11.2285.2285 ◽

2007 ◽

Vol 110 (11) ◽

pp. 2285-2285 ◽

Cited By ~ 1

Author(s):

Jun Eun Park ◽

Hyun Joo Jung ◽

Chul-Ho Kim ◽

Jeong Hong ◽

Jae Ho Han

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Medical Center ◽

University Hospital ◽

First Episode ◽

Excision Biopsy ◽

Cervical Lymph Nodes ◽

Korean Children ◽

Presenting Symptoms

Abstract OBJECTIVES: Kikuchi’s disease (KD) is a benign, self-limiting disorder of unknown origin with lymphadenopathy and fever, and prevalent in young Asian women. The initial presentations mimic malignancies or other serious infections, and the biopsy of lymph nodes affected is the only definite diagnostic tool of KD. We analyzed data from a series of pediatric cases collected at a single medical center and suggest proper guideline of management for patients with KD. METHODS: The medical records of children under 16 years of age, who underwent lymph node biopsies and received histiopathologic diagnosis of KD at Ajou University Hospital, South Korea from January 2000 to June 2007, were retrospectively reviewed. RESULTS: Twenty six pediatric patients with KD included 10 boys and 16 girls. In all cases except two, the cervical lymph nodes were involved. Twenty (76.9%) patients had fever as a presenting symptom, and 5 patients (19.2%) had various skin rash. Leukopenia was noted in 8 cases (30.8%), but there was no case of leukocytosis. The levels of ESR and LDH were slightly elevated, but CRP and liver enzymes were within normal range. No KD patients in this study developed any other autoimmune disorders during follow-up period. Eleven (55%) cases with fever improved immediately after excision biopsy of affected lymph nodes. Eight (30.8%) cases treated with steroid showed dramatic responses. Six patients (23.1%) had resolutions of symptoms simply with symptomatic treatments. The recurrence happened in 6 (23.1%) children within a few weeks from the first episode. CONCLUSIONS: Contrary to previous reports on Asian cases, KD in Korean children is not rare in young boys, and fever is more common presenting symptoms. It’s relationship with autoimmune diseases or infection of EBV is not clear. Symptoms such as fever improved in some cases only by the removal of affected lymph node for excision biopsy. In agreement with previous reports, patients treated with steroid recovered dramatically. Therefore, we suggest an earlier excision biopsy for patients suspicious with KD and an immediate treatment of cases with severe symptoms with steroid. The recurrence rate in this study was higher than that in previous studies, therefore, a spell of follow-up period after disappearance of symptoms is advisable for patients with original diagnosis of KD.

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The Clinical and Histological Characterization of Malignant Lymphoma, Kikuchi-Fujimoto Disease and L-Forms Acid-Fast Bacillus Infection

Blood ◽

10.1182/blood.v112.11.5275.5275 ◽

2008 ◽

Vol 112 (11) ◽

pp. 5275-5275

Author(s):

Jie He ◽

Rui-ping Li ◽

Jian-hua Wang ◽

Bao-An Chen

Keyword(s):

Lymph Nodes ◽

Malignant Lymphoma ◽

Antibiotic Treatment ◽

Acid Fast Bacillus ◽

Cervical Region ◽

Excision Biopsy ◽

Cervical Lymph Nodes ◽

Inappropriate Treatment ◽

Acid Test

Abstract Objective: Malignant lymphoma (ML), Kikuchi-Fuljimoto disease (KFD) and L-forms Acid-fast bacillus infection (L-forms TB) usually affect the cervical lymph nodes. KFD and L-form TB are often confused with ML and take misdiagnosis and inappropriate treatment. The diagnosed of these diseases is on basis of an excision biopsy of affected lymph nodes. Methods: We analyzed 63 patients (including case diagnosed in our hospital) by clinical characteristic, laboratory, pathological morphology, histochemistry and immunohistochemistry. Results: Of 63 cases, 43 were ML, 17 were KFD and 3 were L-forms TB. In ML disease, 46% were male and 54% were female, mean age was 54 (11–82). 9% cases have persistent fever and associated with hepatosplenomegaly. In KFD, 47% were male and 53% were female, mean age was 26 (17–45). 59% cases with cervical hymphadenopath and no fever, 41% had painful, accompanied by fever. hepathosplenomegaly, occasionally leucopenia and lypadenopathy especially involving cervical region not responsive to antibiotic treatment. 29% lymph tissues were morphologically, and characterized by a necrosis in the cortical or paracortical areas of enlarged lymph node around the necrotic area. T lymphocytes were found and absence of granulocytes. 30% cases were mistaken to ML. L-forms TB disease, there were fever, clinical and histological were similar KFD and ML. 3 cases were misdiagnosis to ML or KFD. Laboratory analyses: PAM and PAS were positive, and anti acid test to found L-forms bacterium in tissues. Conclusions: Kikuchi-Fujimoto disease and L-forms Acid-Fast bacillus infection are easily confused histological and clinically with malignant lymphoma. Clinicians and pathologists must be aware of this condition. Although Malignant lymphoma, Kikuchi-Fujimoto disease and L-forms Acid-fast bacillus infection can be found any age, but should be considered for malignant lymphoma in older patients. Kikuchi-Fujimoto disease is predominantly a self-limiting disease of the young and most cases with fever, nodal biopsy showing fragmentation necrosis and karyorrhexis, not responsive to antibiotic treatment. In the L-forms Acid-fast bacillus infection, the PAM and PAS are positive, and have an effective antibiotic treatment.

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Kikuchi-Fujimoto Disease: A Case Report and Literature Review

Case Reports in Otolaryngology ◽

10.1155/2012/497604 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 4

Author(s):

Vikrant Veer ◽

Albert Lim ◽

Wolfgang Issing

Keyword(s):

Case Report ◽

Literature Review ◽

Lymph Nodes ◽

Needle Aspiration ◽

Excision Biopsy ◽

Asian Countries ◽

Histiocytic Necrotising Lymphadenitis ◽

History Of ◽

Reticular Cells ◽

The Uk

Case. 38-year-old lady was referred to the ENT clinic with history of right-sided facial pain, otalgia, and odynophagia. Clinical examination revealed enlarged right-sided lymph nodes in the neck. Further radiological scans showed a mass near the carotid and enlarged level V lymph nodes. Lymphoma was initially suspected. Fine-needle aspiration and excision biopsy were undertaken. Histological analysis later suggested Kikuchi-Fujimoto disease, also known as histiocytic necrotising lymphadenitis.Literature Review. Kikuchi-Fujimoto disease (KFD) was described in 1972 as lymphadenitis with focal proliferation of reticular cells accompanied by numerous histiocytes and extensive nuclear debris. KFD, frequently found in East Asian countries, is rare in the UK. No definite aetiology of KFD is known despite autoimmune and infection factors being suggested. The diagnostic hallmark is histological findings from lymph nodes. Malignancy should be excluded. This condition is mainly self-limiting; hence, management is limited to supportive care. Steroid therapy could be used in severe cases. KFD is relatively unknown in the UK and this case report aims to highlight its occurrence in our population.

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Burkitt-like lymphoma with 11q aberration in a patient with AIDS and a patient without AIDS: Two cases reports and literature review

Open Medicine ◽

10.1515/med-2021-0246 ◽

2021 ◽

Vol 16 (1) ◽

pp. 428-434

Author(s):

Jing Wang ◽

Li Ma ◽

Jianghong Guo ◽

Yanfeng Xi ◽

Enwei Xu

Keyword(s):

Partial Response ◽

Literature Review ◽

Lymph Nodes ◽

Burkitt Lymphoma ◽

Complete Response ◽

Clinicopathological Features ◽

Cervical Lymph Nodes ◽

Cervical Mass ◽

The Right

Abstract Objective The aim of this study is to evaluate the clinicopathological features and the treatment of the Burkitt-like lymphoma with 11q aberration. Methods We reported two patients with Burkitt-like lymphoma with 11q aberration: a 56-year-old man with AIDS (case 1) and a 37-year-old woman (case 2) without AIDS. The biopsy of cervical lymph nodes showed Burkitt-like morphologic and immunophenotypic features. But both of them lack MYC rearrangement and carry an 11q-arm aberration with proximal gains and/or telomeric losses. The diagnosis was confirmed by pathological morphology, immunohistochemistry, and fluorescence in situ hybridization. Result After a cycle of R-CTOEP (rituximab, cyclophosphamide, pirarubicin, vincristine, and prednisone) chemotherapy, case 1 refused to chemotherapy and radiotherapy and was followed up for 34 months without recurrence and new focus. Case 2 received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) for two cycles and achieved PR (partial response). Then, the patient in case 2 received EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) for three cycles, and the right cervical mass disappeared. She achieved complete response and was followed up for 16 months without recurrence and new focus. Conclusion Burkitt-like lymphoma with 11q abnormalities resembles Burkitt lymphoma morphologically but lacks MYC rearrangement and may have a better prognosis.

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Mengenal gambaran ultrasound lesi jinak, ganas dan metastasis pada nodus limfa leher menggunakan ultrasonografi

Jurnal Radiologi Dentomaksilofasial Indonesia ◽

10.32793/jrdi.v3i3.442 ◽

2020 ◽

Vol 3 (3) ◽

pp. 21

Author(s):

Lusi Epsilawati ◽

Hendra Polii ◽

Erna Herawati

Keyword(s):

Literature Review ◽

Lymph Nodes ◽

Ultrasound Imaging ◽

Cervical Lymph Nodes ◽

Imaging Characteristic ◽

Pathological Conditions ◽

Different Characteristics ◽

Neck Lymph Nodes

Objectives: This study is aimed to review the ultrasound imaging (USG) of benign, malignant and metastases lesions in cervical lymph nodes. Literature Review: This article was written based on some scientific literatures in which will explain the interpretation technique and imaging characteristic to distinguish between benign, malignancies and metastases lesions in cervical lymph nodes through ultrasound imaging. There are many pathological conditions may occur in cervical lymph nodes that can be analyzed in ultrasound. The signs of benign, malignant and metastases lesions in cervical lymph nodes, all may have different characteristics. Those characteristics could help the practitioners and radiologists to distinguish the lesions based on several assessment categories. Hopefully, the reader of this article could understand the technique to distinguish benign, malignant and metastases lesions in neck lymph nodes in ultrasound. Conclusion: Ultrasonography is the most commonly used modality for lymph nodes examination, although the accuracy cannot be trusted or guaranteed 100% but this modality always be used and becoming one of all choices. Through the ultrasound, it could be concluded that some of the characteristics of the assessment can be a guide to distinguish benign, malignant and metastases lesions in cervical lymph nodes.

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