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Turkish Journal of Cancer
2004, Volume 34, Number 4, Page(s) 156-162
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The value of qualitative and semiquantitative ultrasonographic findings in the differential diagnosis of lymphomatous superficial lymph node enlargements
ÖZERK ÖMÜR ÖKTEN1, NERMİN TUNÇBİLEK1, HAKKI MUAMMER KARAKAŞ2
1Trakya University Faculty of Medicine, Department of Radiology, Edirne-Turkey
2İnönü University Faculty of Medicine, Turgut Özal Medical Center, Department of Radiology, Malatya-Turkey

The value of the gray-scale (GSUSG), color Doppler (CDUSG), and power Doppler (PDUSG) ultrasonography in the differential diagnosis of lymphomatous superficial lymph node enlargements were evaluated. The study group consisted of 33 males and 16 females (5-74 yrs old, mean age 36.1 yrs) in whom physical examination had revealed superficial lymph node enlargements. All patients were investigated with Doppler USG (Sonoline Elegra Advanced, Siemens, Germany) using 7.5 Mhz linear transducer. Longitudinal/ transverse dimensions (L/T) and hilar echogenecity of lymph nodes were evaluated with GSUSG. During the CDUSG and PDUSG examination, we classified the nodes into 3 patterns: type I, “hilar normal”; type II, “hilar activated”; and type III, “peripheral”. Pulsatility (PI) and resistivity (RI) indexes were calculated using CDUSG. Above parameters were analyzed to determine their differential diagnostic values using ANOVA based discriminant analysis, Student’s- T test and ROC curve analysis. When clinical data and histopathological findings were combined, 27 subjects were diagnosed as lymphoma, and 22 cases were classified as lymphadenitis. Multiple comparison analysis of qualitative GSUSG and PDUSG features consisting of hilar echogenecity, L/T value and vascular type patterns was able to differentiate lymphomatous lymph nodes and lymphadenitis with 86.8% accuracy (p<0.001). On the contrary, semiquantitative features (RI, PI) were not able to classify lymph nodes (p>0.05). Semiquantitative RDUS parameters are not valuable in the differential diagnosis of lymphomatous superficial lymph node pathologies. Qualitative GSUSG and PDUSG features, on the other hand, may be used as an alternative work-up to cytological studies in patients in whom diagnostic surgical procedures cannot be performed. [Turk J Cancer 2004;34(4):156-162]

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