Ultrasonic evaluation of cervical metastatic lymphadenopathy

We investigated the location, size, and shape of cervical lymph nodes in head and neck cancer, using a 7.5-MHz ultrasound scanner. First, the different criteria for normal size were obtained for cervical lymph nodes in each region; lymph nodes greater than 9 mm in thickness in the internal jugular chain or greater than 7 mm in thickness in the submandibular and submental chains should be suspected of harboring metastatic foci. Second, metastatic nodes showed a more rounded configuration than nonmetastatic ones. Third, a comparative study of metastatic lymph nodes between the in vivo and in vitro ultrasonograms and the corresponding histopathological findings disclosed that an echogenic region in an ultrasonogram of a metastatic node was caused by coagulation necrosis, and a cystic area of liquefaction necrosis.