Sonographic evaluation of anterior cervical lymph nodes

In this study we evaluated the role of ultrasound in diagnosis of anterior cervical lymph (ACL) node disease. Three-hundred and sixty-six patients were included in the study. When ACL nodes were found, we noted the station(s) involved, the number, and the short and long axis of each. Patients had their thyroid investigated and were then divided into four groups: no sonographic signs of thyroid abnormality, already diagnosed autoimmune thyroiditis, probable new diagnosis of autoimmune thyroiditis, and thyroid nodules. ACL nodes were found in 127 out of 366 patients examined. The 127 patients with ACL nodes were classified into group 1 (2 patients), group 2 (97 patients), group 3 (23 patients), and group 4 (5 patients). The only differences were the presence and number of lymph nodes in the prelaryngeal and/or prethyroidal and/or pretracheal stations, and the number of "acutely inflamed" nodes in group 3 compared with all the other groups. We observed a strong association between anterior cervical lymphadenopathy and autoimmune thyroiditis; this is certainly a good reason to justify thorough evaluation of anterior cervical lymph nodes for all patients with suspected thyroiditis.