I had a CT scan done for suspected lymphoma because of high CRP, ESR, WBC, night sweats, and intermittent fever. It was found that there was a mass next to my trachea apart from the thyroid gland and they recommended that I have an ultrasound. Can you please review my ultrasound?
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I have reviewed the ultrasound images of neck provided by you (attachment removed to protect patient identity). There is a well defined hypoechoic nodule of size 1.8x1.4x0.6cm in left lateral neck with preserved central hilum- highly likely to be an enlarged cervical lymph node. No vascularity noted in it on color doppler. Rest of the left lateral neck is normal. Right lateral neck appears normal. Both lobes of thyroid appear normal. Neck vessels in 2D appear normal. Color doppler of vessels not provided. Isthmus is normal.
P.S. Ultrasound is not the modality of choice to comment on trachea and lesions associated with it. This nodule is oval in shape, has a preserved central hilum and does not show any hilar or peripheral vascularity on color doppler. These features point towards its benign nature. However, in light of the disease being investigated, FNAC of the nodule is suggested.
Thank you doctor,
The previous CT scan noted that there was the following lesion found, is that the lesion that they identified on the ultrasound?
Nonspecific soft tissue abnormality which appears distinct from the thyroid, gland measuring 1.6 x 0.7 cm that could correlate with parathyroid lesion or exophytic thyroid lesion. Correlation with ultrasound may be helpful for further evaluation as warranted clinically. No other neck mass or significant adenopathy is identified.
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The lesion or nodule in the left neck measured on ultrasound is highly suggestive of a enlarged lymph node based on its typical features and location in the neck .However, FNAC would help in the definitive diagnosis of this lesion. The lesion mentioned on the CT report is not visible clearly on the ultrasound images provided. Doppler examination of the region adjacent/close to the the thyroid glands (common place for parathyroid lesions) would have helped to differentiate normal neck vessels from an abnormal mass.
CT provides a more detailed evaluation than the ultrasound of masses/lesions as it has a better spatial resolution and the contrast given makes lesions more conspicuous. Findings can be missed on ultrasound especially small lesions as it is a very operator dependent modality.
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