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Fig. 10 | Insights into Imaging

Fig. 10

From: Ultrasound imaging of the axilla

Fig. 10

A glance-in-depth at the multiparametric sonographic assessment of lymph nodes. Benign lymphadenopathy (A) usually preserves the hyperechoic hilum (H), the hypoechoic cortex (C) and a unipolar vascularization with feeding vessels branching from the hilum to the cortex (B, C) Instead, a disappearance of the hilum (D), a rounded/globular shape (E) and a multipolar vascularization (F) with feeding vessels (red arrowheads) originating from the peripheral portion, can be considered the most common sonographic findings of malignant lymphadenopathy. Of note, considering the extreme variability of sonographic patterns of lymph nodes, several “atypical” findings can be identified in daily practice—e.g., serpiginous protrusions (white arrowhead) related to ectatic vessels (red arrowhead) (G, H) a normal lymph node (white dotted line) coupled with a “snowfall” lymph node (green arrowheads) due to particle depositions (I, L) eccentric thickening of the cortex (white asterisks) with lateral displacement of the hilum (H) (M). PD: power doppler; CD: color doppler

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