The macro-calcifications, the areas of fibrosis and the presence of modest Doppler signals for the cortex appear to have little significance, at least with respect to metastases. In conclusion, in the presence of the described anomalies (i.e., high number of lymph nodes, increased size, small lobulations of the
outline, altered contour morphology, selleck compound inhomogeneity or slight thickening of the cortex, anomalous hilus, and mild abnormal vascular pattern), we recommend clinical and US follow-up without additional invasive procedures, so as to avoid unnecessary stress to the patient and significant additional costs. However, an additional US control performed shortly after the first appears to be a reasonable and cost-effective solution, without running the risk of a poor prognosis because of initially unrecognized metastatic lesions. Electronic supplementary material Additional file 1: Attachment. Protocol for selleck products inguinal lymph nodes: Patients undergoing follow-up for neoplastic pathologies for 1 year. (DOC 36 KB) References
1. De Carvalho JP, Patrício BF, Medeiros J, Sampaio FJ, Favorito LA: Anatomic aspects of inguinal lymph nodes applied to lymphadenectomy in penile cancer. Adv Urol 2011., 952532: 2. Testut L, Latarjet A: Trattato di anatomia umana sistematica. Torino: Utet; 1977. 3. Sapino A, Cassoni P, Zanon E, Fraire F, Croce S, Coluccia C, Donadio M, Bussolati G: Ultrasonographically-guided fine-needle aspiration of axillary lymph nodes: role in breast 4EGI-1 cell line cancer management. Br J Cancer 2003, 88:702–706.PubMedCrossRef 4. Damera A, Evans AJ, Cornford EJ, Wilson AR, Burrell HC, James JJ, Pinder SE, Ellis IO, Lee AH, Macmillan RD: Diagnosis of axillary nodal metastases by ultrasound-guided core biopsy in primary operable breast cancer. Br J Cancer 2003, 89:1310–1313.PubMedCrossRef 5. Deurloo Glycogen branching enzyme EE, Tanis PJ, Gilhuijs KGA, Muller SH, Kröger R, Peterse JL, Rutgers EJ, Valdés Olmos R, Schultze Kool LJ: Reduction in the number of sentinel lymph node procedures by preoperative ultrasonography of the axilla in
breast cancer. Eur J Cancer 2003, 39:1068–1073.PubMedCrossRef 6. Bossi MC, Sanvito S, Lovati E, De Fiori E, Testori A, Bellomi M: Role of high resolution color-Doppler US of the sentinel node in patients with stage I melanoma. Radiol Med 2001,102(5–6):357–62.PubMed 7. Ferrari FS, Cozza S, Guazzi G, Della Sala L, Leoncini L, Lazzi S, Stefani P: Role of Doppler color in the differential diagnosis of benign and malignant adenopathies. Radiol Med 1997,93(3):242–245.PubMed 8. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. Philadelphia, USA: Churchill Livingstone; 2008. 9. Stramare R, Tregnaghi A, Fittà C, Torraco A, Khadivi Y, Rossi CR, Rubaltelli L: High-sensitivity power Doppler imaging of normal superficial lymph nodes. J Clin Ultrasound 2004,32(6):273–276.PubMedCrossRef 10.