'Pseudocystic' appearance of non-Hodgkin's lymphomatous nodes: An infrequent finding with high-resolution transducers

Aims: A pseudo-cystic appearance and posterior enhancement are previously reported to be diagnostic sonographic features of lymph node involvement in non-Hodgkin's lymphoma. This study was undertaken to determine whether these ultrasonic features remain with the use of high-resolution transducers. Materials and Methods: A review of ultrasound examinations in 32 patients with proven lymphomatous cervical lymphadenopathy (27 non-Hodgkin's lymphoma, five Hodgkin's disease) was performed. A total of 95 lymph nodes were assessed for size, shape, posterior enhancement and internal architecture. All examinations were performed with the same high-resolution transducer and by the same sonologist. Results: Lymphomatous nodes (irrespective of type) are frequently heterogeneous (68-86%), have a micronodular pattern (63-69%) and less commonly demonstrate posterior enhancement (9-26%). Conclusion: Using a high-resolution ultrasonic transducer, cervical nodes involved with lymphoma (irrespective of type) commonly demonstrate a heterogeneous micronodular pattern. The pseudocystic appearance of nodes with posterior enhancement in non-Hodgkin's nodes is seen infrequently.