
Is Cortical Thickening Something To Be Concerned About?

TECHNIQUE:
Targeted ultrasound of both axillae.
FINDINGS:
The dominant right axillary lymph node measures 4.1 x 1.2 cm at its
maximum craniocaudal by transverse dimension. The thickness of the
cortex measures 0.6 cm (normal measurement is between 0.2 to 0.3 cm).
Echogenic hilus is well visualized.
The dominant left axillary lymph node measures 3.1 x 1.0 cm at its
maximum craniocaudal by transverse dimension. The cortex measures 0.4
cm (normal measurement is between 0.2 to 0.3 cm). The echogenic hilus
is well visualized.
These lymph nodes have ultrasound criteria for being diagnosed as pathological, please see below for detailed explanations.
Detailed Answer:
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.
The normal findings in ultrasound for the axillary lymph nodes are:
- oval nodes, not more than 2 cm in the maximal diameter
- uniformly thin cortical layer of not more than 3 mm
- presence of fatty hilum
- well preserved margins
In your case you do have a preserved fatty hilum (the inner area) and well-preserved margins (well visualized) but the size of the lymph nodes is bigger than 2 cm in the longer diameter in each of them and the cortical thickness (the outer layer of the lymph node) is more than 3 mm in both cases.
These lymph nodes, according to the ultrasound findings, are considered pathological (abnormal) and further examination (possibly a biopsy) might be indicated to confirm their nature.
Hope I have answered your query.
Let me know if I can assist you further.
Kind regards,
Antoneta Zotaj, MD


These findings tell us the lymphnodes are abnormal but do not specify the cause for it. It should lead to examinations to determine the cause (due to malignancy or infection???).
Detailed Answer:
Hello,
Abnormal means that they have some characteristics different from the normal lympnodes. The ultrasound findings do not give clear clue for the cause of it.
If the hilum fat was not preserved and if the margins were not well defined than it would be very likely related to malignancy. In your case you do not have these 2 characteristics and it is a good sign.
On the other hand cortical thickening and increase of the lymphnode in size are not normal findings either. Both malignancy and reactive lymphnodes (due to infection) can cause these 2 changes you have and their real cause needs to be determined with other tests and examinations.
Hope I have answered your query.
Let me know if I can assist you further.
Kind regards,
Antoneta Zotaj, MD


Most Welcome
Detailed Answer:
Hello,
It is a pleasure to be able to assist you.
Stay well and kind regards,
Antoneta Zotaj, MD

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