Characterization of cervicofacial lymphnodes - a clinical and ultrasonographic study

Lymph nodes undergo reactive changes in response to a wide variety of stimuli, the most common cause being inflammatory and immune reactions, apart from primary malignant neoplasms and metastatic tumours. It is well accepted that a clinical examination alone cannot be considered diagnostic to justify the involvement of cervicofacial lymph nodes especially deep and small nodes. Ultrasonography is an easy, reproducible, non invasive, non-ionizing imaging modality to evaluate cervicofacial lymph nodes.

The present study was devised with an aim of comparing the clinical and ultrasonographic features of cervicofacial lymphadenopathy.

The subjects for the study were selected from the patients who visited the outpatient department with clinically palpable lymph nodes. Fifty two patients were included in the study and they were divided into 4 groups; group I (subjects with odontogenic infections), group II (subjects with non odontogenic oral conditions), group III (subjects with tuberculosis) and group IV (subjects with head and neck carcinomas). A detailed case history was recorded and a thorough clinical examination was carried out for all subjects. The cervicofacial lymph nodes were palpated and examined. Ultrasonographic examination of cervicofacial lymph nodes was carried out and recorded. The statistical analysis was done using chi square test.

Most of the subjects considered for the study showed cervicofacial lymphadenopathy associated with odontogenic causes, specific infections like tuberculosis and head and neck malignancies. The lymph nodes showed varied clinical features. The ultrasonographic features such as number, size, shape, short axis/long axis ratio, border sharpness, hilum, echogenicity, distribution of the internal echoes, intranodal necrosis, matting or soft tissue edema were evaluated. The results were tabulated and statistical analysis was done.