Small arteries in peripheral lymph nodes: a specific US sign of lymphomatous involvement

Fifty-seven patients with palpably enlarged peripheral lymph nodes underwent detailed ultrasonographic (US) examination with a 5.0-MHz and a 7.5-MHz probe. In 32 of 36 patients with malignant lymphoma (12 with Hodgkin disease, 24 with non-Hodgkin lymphoma) US showed a hypoechoic mass with a centrally located tubular structure. Pathologic examination showed that this structure correlated with small intact arterial vessels encased by confluent lymphomatous masses. This sonographic finding was not seen in patients with carcinomatous metastatic lesions to the lymph nodes (nine patients) or benign lymphadenitis (12 patients). The detection with US of small arteries within enlarged lymph nodes may indicate nodal infiltration by malignant lymphoma.