Evaluating the reliability of ultrasonographic parameters in differentiating benign from malignant superficial lymphadenopathy

Diagnosis of malignant lymphadenopathy is of particular importance for treatment planning, before treatment staging and also for prognosis determination. Currently various diagnostic procedures are used to differentiate benign and malignant lymphadenopathy which are invasive and costly. Ultrasonography as a noninvasive, low-cost and accessible method is proposed. The aim of this study was to evaluate the reliability of some ultrasonographic parameters in differentiating malignant from benign superficial lymphadenopathies. In this study ultrasonography was performed for lymph nodes of 100 patients who were eligible for pathological evaluation of superficial lymphadenopathy. The most accessible lymph nodes were marked and biopsied. Sonographic and pathologic results were compared. The sensitivity and specificity of the test and the appropriate cutoff point was determined based on the Receiver Operating Characteristics (ROC) curve using SPSS Ver.17. From 100 evaluated lymph nodes 55 were benign and 45 were malignant. There was no significant difference between malignant and benign lymph nodes in terms of cortical and medullary thickness (p=0.055), but there was a significant difference between benign and malignant lymph nodes in terms of blood supply pattern and mean of Pulsatility Index (PI) (P=.007) and Resistive Index (RI) (P<0.001). The cortex thickness of 7.95 mm with 62.2. sensitivity, 72.7. specificity and 70. accuracy was the appropriate cutoff point in differentiating malignant and benign lymphadenopathy. The color Doppler criteria in combination with gray scale ultrasonography could be helpful to select patients for biopsy or Fine Needle Aspiration (FNA), but cannot fully replace pathological evaluation.