Abstract

Background: Cervical lymphadenopathy represents a frequent clinical problem with causes ranging from benign inflammatory conditions to malignant disorders. Precise characterization is crucial to determine appropriate management and to reduce unnecessary invasive procedures. Ultrasonography has been shown to be superior to clinical palpation in detecting and evaluating cervical lymph nodes.
Objective: To assess cervical lymph nodes using gray-scale ultrasonography, colour Doppler imaging, and elastography, and to correlate sonographic findings with fine-needle aspiration cytology (FNAC).
Materials and Methods: This prospective observational study included patients presenting with cervical lymphadenopathy who underwent ultrasonographic evaluation. Gray-scale morphological features, Doppler vascular patterns, and elastographic strain ratios were documented and compared with FNAC or histopathological results.
Results: Reactive lymphadenopathy constituted the most common benign diagnosis. Malignant lymph nodes were more frequently round, demonstrated loss of echogenic hilum, heterogeneous echotexture, sharp margins, peripheral or mixed vascularity, and increased stiffness on elastography. Combined assessment using B-mode ultrasound and elastography yielded higher diagnostic accuracy than gray-scale imaging alone.
Conclusion: Ultrasonography supplemented with colour Doppler and elastography is a reliable, non-invasive modality for evaluating cervical lymphadenopathy. The integration of multiple sonographic parameters significantly improves differentiation between benign and malignant lymph nodes when correlated with FNAC findings.