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Cervical lymphadenopathy: ratio of long- to short-axis diameter as a predictor of malignancy

Strahlenklinik und Poliklinik, Universitätsklinikum Rudolf Virchow, Freie Universität Berlin, Augustenburger Platz 1, 13353 Berlin, Germany

The purpose of this study was to evaluate short- and long-axis diameters of enlarged cervical lymph nodes with ultrasonography and to determine whether the long-to-short axis (1/s) ratio is a valid diagnostic parameter in the differentiation between benign and malignant nodal disease. 730 enlarged cervical lymph nodes in 285 patients were examined with ultrasound. The short- and the long-axis diameters of each enlarged node were measured and the 1/s ratio calculated. Definite diagnoses of the nodes were obtained by histological examination following neck dissection. 95% of enlarged cervical nodes shown on ultrasound to have a 1/s ratio of more than 2 were correctly diagnosed as benign. Nodes presenting with a more circular shape and a 1/s ratio of less than 2 were diagnosed correctly as metastases with 95% accuracy. The 1/s ratio of lymph nodes thus provides an excellent criterion for differentiation between benign and malignant enlargement in cervical lymphadenopathy.

Received for publication February 22, 1994. Accepted for publication November 25, 1994.

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