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Updated: Aug 15, 2026
Synchronous Triplanar Reconstruction Integrated with Color Doppler Mapping for Precise and Rapid Localization of Thyroid Lesions
Published on: February 9, 2024
Ultrasonographic differentiation between metastatic and benign lymph nodes in patients with papillary thyroid
Pedro Weslley Souza Rosário1, Sérgio de Faria, Luciano Bicalho
1Centro de Estudos e Pesquisa da Clinica de Endocrinologia e Metabologia, Avenida Francisco Sales 1111, 5 Andar Ala D, Santa Efigênia, 30150-221 Belo Horizonte-MG, Brazil. pedrorosario@globo.com
Objective:
The purpose of this study was to evaluate the ultrasonographic characteristics of metastatic lymph nodes in patients with papillary thyroid carcinoma.
Methods:
The ultrasonographic characteristics of lymph nodes were analyzed in 112 consecutive patients who underwent thyroidectomy and lymph node dissection, with the diagnosis being confirmed by anatomopathologic examination.
Results:
A total of 198 lymph nodes were metastatic, and 152 were benign (normal or with nonspecific lymphadenitis). Minimum axial diameters of 7 mm for level II (upper internal jugular chain) and 6 mm for the rest of the neck were observed in 93% of metastatic lymph nodes, absence of an echogenic hilum in 88%, hyperechogenicity in relation to the adjacent muscles in 86%, a round shape in 80%, calcifications in 49.5%, and intranodal cystic necrosis in 20%. These ultrasonographic characteristics were observed in 17%, 10%, 4.5%, 29.5%, 0%, and 0% of benign lymph nodes, respectively.
Conclusions:
Even basic ultrasonographic characteristics (shape, echogenicity and echogenic hilum, calcifications, and intranodal cystic necrosis) help in the differentiation between metastatic and nonmetastatic lymph nodes in patients with papillary thyroid carcinoma.