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Systemic Nodal Metastases in Neck
Surjith Vattoth, MD, FRCR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Cervical metastatic adenopathy in systemic malignancy from infraclavicular primary tumor
                • Virchow node is left supraclavicular nodal metastasis
                  • Usually abdominal or pelvic primary malignancy

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            Selected References

                                            1. Nie J et al: The value of CEUS in distinguishing cancerous lymph nodes from the primary lymphoma of the head and neck. Front Oncol. 10:473, 2020
                                            2. Dangore SB et al: Evaluation of the efficacy of colour Doppler ultrasound in diagnosis of cervical lymphadenopathy. Dentomaxillofac Radiol. 37(4):205-12, 2008
                                            3. Chan JM et al: Ultrasonography of abnormal neck lymph nodes. Ultrasound Q. 23(1):47-54, 2007
                                            4. King AD et al: Malignant cervical lymphadenopathy: diagnostic accuracy of diffusion-weighted MR imaging. Radiology. 245(3):806-13, 2007
                                            5. Zenk J et al: Neck lymph nodes: prediction by computer-assisted contrast medium analysis? Ultrasound Med Biol. 33(2):246-53, 2007
                                            6. Abdel Razek AA et al: Role of diffusion-weighted MR imaging in cervical lymphadenopathy. Eur Radiol. 16(7):1468-77, 2006
                                            7. Yano M et al: Prognosis of patients who develop cervical lymph node recurrence following curative resection for thoracic esophageal cancer. Dis Esophagus. 19(2):73-7, 2006
                                            8. King AD et al: Human cervical lymphadenopathy: evaluation with in vivo 1H-MRS at 1.5 T. Clin Radiol. 60(5):592-8, 2005
                                            9. Mevio E et al: The role of positron emission tomography (PET) in the management of cervical lymph nodes metastases from an unknown primary tumour. Acta Otorhinolaryngol Ital. 24(6):342-7, 2004
                                            10. Fischbein NJ et al: Assessment of metastatic cervical adenopathy using dynamic contrast-enhanced MR imaging. AJNR Am J Neuroradiol. 24(3):301-11, 2003
                                            11. Giridharan W et al: Lymph node metastases in the lower neck. Clin Otolaryngol. 28(3):221-6, 2003
                                            12. Weissman JL: Building a better mousetrap: the diagnosis of metastatic cervical adenopathy. AJNR Am J Neuroradiol. 24(3):297, 2003
                                            13. Ahuja A et al: An overview of neck node sonography. Invest Radiol. 37(6):333-42, 2002
                                            14. Sato F et al: Paratracheal lymph node metastasis is associated with cervical lymph node metastasis in patients with thoracic esophageal squamous cell carcinoma. Ann Surg Oncol. 9(1):65-70, 2002
                                            15. Steinkamp HJ et al: Current status of power Doppler and color Doppler sonography in the differential diagnosis of lymph node lesions. Eur Radiol. 12(7):1785-93, 2002
                                            16. Zuur CL et al: Diagnosis and treatment of isolated neck metastases of adenocarcinomas. Eur J Surg Oncol. 28(2):147-52, 2002
                                            17. Ahuja A et al: Lymph node hilus: gray scale and power Doppler sonography of cervical nodes. J Ultrasound Med. 20(9):987-92; quiz 994, 2001
                                            18. Ahuja A et al: Power Doppler sonography of cervical lymphadenopathy. Clin Radiol. 56(12):965-9, 2001
                                            19. Asai S et al: Ultrasonographic differentiation between tuberculous lymphadenitis and malignant lymph nodes. J Ultrasound Med. 20(5):533-8, 2001
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Definitions

                                                          • Cervical metastatic adenopathy in systemic malignancy from infraclavicular primary tumor
                                                          • Virchow node is left supraclavicular nodal metastasis
                                                            • Usually abdominal or pelvic primary malignancy

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Ultrasonographic Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Staging, Grading, & Classification

                                                                        • Gross Pathologic & Surgical Features

                                                                          • Microscopic Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Consider

                                                                                      Selected References

                                                                                      1. Nie J et al: The value of CEUS in distinguishing cancerous lymph nodes from the primary lymphoma of the head and neck. Front Oncol. 10:473, 2020
                                                                                      2. Dangore SB et al: Evaluation of the efficacy of colour Doppler ultrasound in diagnosis of cervical lymphadenopathy. Dentomaxillofac Radiol. 37(4):205-12, 2008
                                                                                      3. Chan JM et al: Ultrasonography of abnormal neck lymph nodes. Ultrasound Q. 23(1):47-54, 2007
                                                                                      4. King AD et al: Malignant cervical lymphadenopathy: diagnostic accuracy of diffusion-weighted MR imaging. Radiology. 245(3):806-13, 2007
                                                                                      5. Zenk J et al: Neck lymph nodes: prediction by computer-assisted contrast medium analysis? Ultrasound Med Biol. 33(2):246-53, 2007
                                                                                      6. Abdel Razek AA et al: Role of diffusion-weighted MR imaging in cervical lymphadenopathy. Eur Radiol. 16(7):1468-77, 2006
                                                                                      7. Yano M et al: Prognosis of patients who develop cervical lymph node recurrence following curative resection for thoracic esophageal cancer. Dis Esophagus. 19(2):73-7, 2006
                                                                                      8. King AD et al: Human cervical lymphadenopathy: evaluation with in vivo 1H-MRS at 1.5 T. Clin Radiol. 60(5):592-8, 2005
                                                                                      9. Mevio E et al: The role of positron emission tomography (PET) in the management of cervical lymph nodes metastases from an unknown primary tumour. Acta Otorhinolaryngol Ital. 24(6):342-7, 2004
                                                                                      10. Fischbein NJ et al: Assessment of metastatic cervical adenopathy using dynamic contrast-enhanced MR imaging. AJNR Am J Neuroradiol. 24(3):301-11, 2003
                                                                                      11. Giridharan W et al: Lymph node metastases in the lower neck. Clin Otolaryngol. 28(3):221-6, 2003
                                                                                      12. Weissman JL: Building a better mousetrap: the diagnosis of metastatic cervical adenopathy. AJNR Am J Neuroradiol. 24(3):297, 2003
                                                                                      13. Ahuja A et al: An overview of neck node sonography. Invest Radiol. 37(6):333-42, 2002
                                                                                      14. Sato F et al: Paratracheal lymph node metastasis is associated with cervical lymph node metastasis in patients with thoracic esophageal squamous cell carcinoma. Ann Surg Oncol. 9(1):65-70, 2002
                                                                                      15. Steinkamp HJ et al: Current status of power Doppler and color Doppler sonography in the differential diagnosis of lymph node lesions. Eur Radiol. 12(7):1785-93, 2002
                                                                                      16. Zuur CL et al: Diagnosis and treatment of isolated neck metastases of adenocarcinomas. Eur J Surg Oncol. 28(2):147-52, 2002
                                                                                      17. Ahuja A et al: Lymph node hilus: gray scale and power Doppler sonography of cervical nodes. J Ultrasound Med. 20(9):987-92; quiz 994, 2001
                                                                                      18. Ahuja A et al: Power Doppler sonography of cervical lymphadenopathy. Clin Radiol. 56(12):965-9, 2001
                                                                                      19. Asai S et al: Ultrasonographic differentiation between tuberculous lymphadenitis and malignant lymph nodes. J Ultrasound Med. 20(5):533-8, 2001