Role of Ultrasonography in Evaluation of Cervical Lymphadenopathy

Abstract

Background: Enlargement of cervical lymph nodes is a very common condition in developing country like Nepal due to many underlying pathologies. Ultrasonography supercedes CT and MRI because it is easily available, cost-effective, noninvasive,
radiation free and hence, a safe investigation. In this study, the ultrasonographic findings of cervical lymphadenopathy were
COITelated with the FNAC reports.
Methods: All the patients presenting in the Department of Radiology with cervical lymphadenopathy underwent  ultrasonographic examination of their neck lymph nodes followed by Fine Needle Aspiration Cytology (FNAC) of the most
representative lymph node. Ultrasound findings and FNAC results were then correlated Statistical analysis and calculation of 'p values' was done by chi-square test. P-value <0.05 was considered as significant.
Results: The frequently affected age group was 5-20 years accounting for 67.5% (54) cases. Of this, 35.0% (28) cases were female patients while 32.5% (26) cases were male. The mean age was 19.2 years. Most of the malignant lymph nodes were found in
male patients which were 3.7% (3) of total cases while reactive & tubercular lymph nodes were found in 22.5% (18) and 36.2% (29) cases respectively. The later were found more common in female. Out of 80 cases of cervical lymphadenopathy, 95% were non-neoplastic and only 5% were neoplastic. Most common finding in nonneoplastic (benign) cervical lymphadenopathy was reactive lymph nodes, seen in 55% ( 44) cases followed by tuberculosis 37.5% (30) cases and while only 5% ( 4) cases were malignant.
Conclusion: In this study, 6 cases were diagnosed as malignant lymphadenopathy by ultrasound but only 4 cases were proved malignant by FNAC. Out of 4 cases, 3. 7% (3) cases were < 1 cm in size and only 1 case was > 1 cm size. The sensitivity and specificity of USG in the evaluation of cervical lymph nodes are 96.1% and 75.0% respectively. The correlation between the ultrasonographic findings with FNAC of cervical lymphadenopathy was statistically significant (p< 0.0001 ).