Lymph Node Basics
This lymph node shape is more suspicious for malignancy.
What is ROUND ?
Often mistaken for a nodule, this structure is found posterior to the left lobe and shows peristalsis when the patient swallows.
What is the ESOPHAGUS ?
This "white line" artifact is commonly seen within colloid cysts and is a sign of benignity.
What is COMET-TAIL ARTIFACT ?
This composition feature earns 0 points and is often described as having a "honeycomb" appearance.
What is SPONGIFORM ?
The "snowstorm" appearance in a lymph node is highly suspicious for metastasis from this specific thyroid cancer.
What is Papillary Thyroid Carcinoma (PTC) ?
This normal feature of a lymph node is a hyperechoic central line; its absence is a red flag.
What is the FATTY HILUM ?
This benign entity often presents as a thick-walled, fluid-filled structure at the midline, superior to the thyroid.
What is a THYROGLOSSAL DUCT CYST ?
This artifact is produced by dense calcifications.
What is POSTERIOR ACOUSTIC SHADOWING ?
This echogenicity level earns 3 points and is defined as being darker than the strap muscles.
What is VERY HYPOECHOIC ?
This rare thyroid cancer may show coarse, dense "chunky" calcifications.
What is Medullary Thyroid Carcinoma (MTC) ?
Normal, healthy lymph nodes in the neck typically resemble this small, edible seed or legume in both shape and size.
What is a BEAN/KIDNEY BEAN ?
When viewed in a cross-section on an ultrasound, this normal neck muscle located directly behind the thyroid gland can easily be mistaken for a dangerous, deep thyroid tumor.
What is the LONGUS COLLI MUSCLE ?
This distinct ultrasound artifact casts thin, dark vertical bands downward from the margins of round structures, caused by the bending of sound waves at tissue borders.
What is REFRACTION OR EDGE SHADOWING ?
A nodule that is "taller-than-wide" earns this many points in the shape category.
What is 3 POINTS ?
This aggressive cancer often presents as a large, rapidly growing mass with invasion into local structures and significant internal necrosis.
What is Anaplastic Thyroid Cancer?
While microcalcifications inside a thyroid nodule are highly suspicious, seeing these identical, tiny bright dots inside a neck lymph node is a virtual guarantee of metastasis from this specific thyroid cancer.
What is PAPILLARY THYROID CARCINOMA (PTC) ?
A "giraffe-skin" or "leopard-spot" appearance (pseudonodular hypoechoic areas) is classic for this autoimmune condition.
What is HASHIMOTO'S THYROIDITIS ?
Over-amplification of echoes returning from behind a benign thyroid cyst causes this bright artifact, proving the lesion is fluid-filled rather than solid tissue.
What is ACOUSTIC ENHANCEMENT ?
Despite their intimidating appearance and ability to completely obscure deeper tissue, this specific type of calcification surprisingly awards fewer TI-RADS points than a tiny, sub-millimeter punctate focus.
What is a MACROCALCIFICATION ?
Unlike papillary thyroid cancer, which spreads through the lymph nodes, this second most common type prefers the highway of the bloodstream to metastasize to the lungs and bones.
What is FOLLICULAR THYROID CARCINOMA ?
If a neck lymph node undergoes this type of liquefying change, turning entirely black and fluid-filled on ultrasound, it is often a dead giveaway for metastatic thyroid cancer or papillary necrosis.
What is CYSTIC DEGENERATION/CYSTIC CHANGE ?
An "incomplete halo" or a thin, regular peripheral rim is usually a reassuring sign, but a thick, irregular halo suggests this.
What is MALIGNANCY (OR FOLLICULAR NEOPLASM)?
This Doppler phenomenon occurs when sound bounces between two highly reflective surfaces (like a calcification) creating a rapid change in color.
What is TWINKLING ARTIFACT ?
According to ACR guidelines, a TR5 nodule must be at least this size (in cm) to warrant a recommendation for FNA.
What is 1 CM ?
When a nodule is classified as MTC (Medullary Thyroid Carcinoma) by molecular testing, clinicians must immediately check for this germline mutation.
What is the RET PROTO-ONCOGENE ?