Don’t Do This – Axillary Lymph Nodes

IMAGING FINDINGS: ​
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Sonographic image of the right axilla demonstrates a normal axillary lymph node with a thin cortex. The sonographer (or radiologist) is incorrectly measuring the dimensions of the lymph node.  

WHY IT MATTERS:

1. Do not measure axillary lymph nodes simply by their greatest dimension. What matters is the cortical thickness and their internal morphology. The lymph node depicted above is totally normal but was errantly stated to be “abnormally enlarged”.  
2. There is no reason to report length x width measurements of axillary lymph nodes on ultrasound, especially if they have a thin cortex and normal morphology.

FURTHER READING:
Axillary Staging of Breast Cancer: What the Radiologist Should Know (RadioGraphics 2013)