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Radiology/Submental lymph node

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Question
Hello.  I asked you a question a few weeks ago (Nov. 22nd) regarding my submental lymph node. Had an ultrasound of my neck because I found a lump.  They put me on augmentin because they think I have an infection. I have been off of the meds for about 10 days now. The lump feels bigger.  A summary of radiology below, prior to meds:
Impression: submental lymph node.  Sub mental well delineated lesion is noted. 1.2x.3x.9cm. Central increased echo texture is noted. Baseline established and follow up can be provided as needed depending on clinical situation.

I have been researching submental lymph nodes and came across a study that showed malignant submental nodes normally have sharp, well-defined borders and are typically round with a s/l ratio greater than 50 percent. If I did my calculations correctly, mine seems to be at 75. The study also said reactive and benign submental nodes tend to be oval with ratio of less than 50 percent.  My node was well defined and is round, if I'm reading correctly. I'm a bit concerned about this. I follow-up with my doc on Wednesday. I wanted your view on this information. Thank you.

Answer
Cindy,

Given the measurements your lymph node is not round like a sphere but rather discoid in shape which is a good shape for a normal or reactive lymph node. Sphere shaped nodes are more concerning at times.  (the literature does refer to "round" lymph nodes as concerning but they actually mean spherical nodes, not round which is a 2D term). It's a poor use of terminology on our part.

Overall most of lymph nodes have well defined borders, benign or malignant, so this particular fact is not the discerning..

Central increased echo texture on US in your case implies a normal fatty hilum (center) of the lymph node which makes it bening.

Michael K.

Radiology

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Michael K.

Expertise

Almost any kind of questions regarding any types of radiology exams, procedures, meaning of radiology reports etc...

Experience

12 year experience in the field of radiology

Organizations
American Society of Neuroradiology, Senior Member Society of Pediatric Radiology, Active Member

Publications
Radiology Seminars in pediatric neurology American Journal of Roentgenology American Journal of Neuroradiology

Education/Credentials
Board Certified in Diagnostic Radiology Additional Certificate of Qualification in Neuroradiology

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