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What Does This Ultrasound Report Indicate?
Question: Axillary Lymph Nodes Enlargement.
Dear Dr. XXXXXXX I read some of your posts and appreciate your detailed answers. So I would like to seek your help on my axillary lymph nodes.
Touched axillary mass without pain in July. Went to doctor and did ultrasound in Aug. The report is below,
EXAM: two prominent oval lymph nodes with preserved fatty hila and with thickened cortices in the right axilla. They're 1.89 x 1.66 x 1.02cm and 1.02 x 1.16 x 0.69cm. Slight increase in vascular flow is also detected.
COMMENT: two prominent lymph nodes with thickened cortices and with increased vascularity. Additional evaluation with mammogram and ultrasound is recommended. Ultrasound guide FNA would also be helpful for evaluation
Since the report didn't say it's malignant suspicious or suggestive benign reactive lymph nodes, I'm very worried for something bad. Please help to remove my worrisome.
My concern is
1. Is Fatty Helia a good indication?
2. If both malignant and benign cells have the characteristics of thickened cortex and increase vascularity, how to distinguish my lymph nodes are malignant or benign?
3. From the report, any signs of malignant?
4. What causes thickened cortex and slight vascularity increased?
5. If it's due to reactive lymphadenitis, why I don't feel pain, no fever and no other symptoms?
6. I don't hurt my arm, no skin irritation of arm pit, no shaving recently, no pain and just swell up, it can still be the cause of reactive lymph nodes?
7. The nodes were less swell-up in late July but a week ago, they swell-up again, is reactive lymphadenitis would cause this?
Sorry I may have too many questions...but after receiving the ultrasound report in Aug, I can't sleep well and depressed. Please help Dr. XXXXXXX
Dear Dr. XXXXXXX I read some of your posts and appreciate your detailed answers. So I would like to seek your help on my axillary lymph nodes.
Touched axillary mass without pain in July. Went to doctor and did ultrasound in Aug. The report is below,
EXAM: two prominent oval lymph nodes with preserved fatty hila and with thickened cortices in the right axilla. They're 1.89 x 1.66 x 1.02cm and 1.02 x 1.16 x 0.69cm. Slight increase in vascular flow is also detected.
COMMENT: two prominent lymph nodes with thickened cortices and with increased vascularity. Additional evaluation with mammogram and ultrasound is recommended. Ultrasound guide FNA would also be helpful for evaluation
Since the report didn't say it's malignant suspicious or suggestive benign reactive lymph nodes, I'm very worried for something bad. Please help to remove my worrisome.
My concern is
1. Is Fatty Helia a good indication?
2. If both malignant and benign cells have the characteristics of thickened cortex and increase vascularity, how to distinguish my lymph nodes are malignant or benign?
3. From the report, any signs of malignant?
4. What causes thickened cortex and slight vascularity increased?
5. If it's due to reactive lymphadenitis, why I don't feel pain, no fever and no other symptoms?
6. I don't hurt my arm, no skin irritation of arm pit, no shaving recently, no pain and just swell up, it can still be the cause of reactive lymph nodes?
7. The nodes were less swell-up in late July but a week ago, they swell-up again, is reactive lymphadenitis would cause this?
Sorry I may have too many questions...but after receiving the ultrasound report in Aug, I can't sleep well and depressed. Please help Dr. XXXXXXX
Brief Answer:
Advised FNAC and mammogram
Detailed Answer:
Dear Miss XXXX, Hi & Welcome to health care magic.
Thanks for your compliments.
I've gone through your query including the the ultrasound scan report of axillary lymph nodes.
Here are the answers for the questions askedL
1. A well preserved fatty hilum is a good sign of most of the normal lymph nodes. However, some cancerous lymph nodes can contain a fatty hilum & still be malignant.
2. A fine needle aspiration cytology (FNAC) or biopsy will differentiate between a benign and a malignant lymph node.
3. No single ultrasound finding is accurate in diagnosing peripheral lymph node malignancy. However, the cortical thickness of more than 2 mm with or without hilar displacement can be suggestive of malignancy.
4. It may be due to inflammation or malignancy.
5. Pain or fever is usually due to an inflammatory process or suppuration. The presence or absence of tenderness does not reliably differentiate benign from malignant nodes.
6. Yes, reactive lymphadenitis can develop in absence of the factors listed.
In most cases it is not a serious disorder, usually being the symptom of an infection or inflammation in progress.
7. Since the size of lymph nodes has increased recently and the fact that there is no associated pain or tenderness, I would advise you to get clinically examined by a surgeon, you may also need to undergo the ultrasound guided FNAC and mammogram to rule out the possibility of malignancy.
Hope I could answer your query. However, if you have any doubt please feel free to ask.
Best wishes.
Advised FNAC and mammogram
Detailed Answer:
Dear Miss XXXX, Hi & Welcome to health care magic.
Thanks for your compliments.
I've gone through your query including the the ultrasound scan report of axillary lymph nodes.
Here are the answers for the questions askedL
1. A well preserved fatty hilum is a good sign of most of the normal lymph nodes. However, some cancerous lymph nodes can contain a fatty hilum & still be malignant.
2. A fine needle aspiration cytology (FNAC) or biopsy will differentiate between a benign and a malignant lymph node.
3. No single ultrasound finding is accurate in diagnosing peripheral lymph node malignancy. However, the cortical thickness of more than 2 mm with or without hilar displacement can be suggestive of malignancy.
4. It may be due to inflammation or malignancy.
5. Pain or fever is usually due to an inflammatory process or suppuration. The presence or absence of tenderness does not reliably differentiate benign from malignant nodes.
6. Yes, reactive lymphadenitis can develop in absence of the factors listed.
In most cases it is not a serious disorder, usually being the symptom of an infection or inflammation in progress.
7. Since the size of lymph nodes has increased recently and the fact that there is no associated pain or tenderness, I would advise you to get clinically examined by a surgeon, you may also need to undergo the ultrasound guided FNAC and mammogram to rule out the possibility of malignancy.
Hope I could answer your query. However, if you have any doubt please feel free to ask.
Best wishes.
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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