Aa
Aa
A
A
A
Close
Avatar universal

Lymph node measurements under US

I recently decided to take a deeper role in keeping tabs on the lymph nodes that have been swollen for some time and noticed a few interesting things. Number one is that while every US report says my cervical lymph nodes aren’t enlarged some do say my submandiblar nodes are but appear normal looking. Now I know at one point it said one of those nodes was 2.4 cm and the most recent report said the largest on that side was 1.3 cm a year later which obviously (assuming its was the same node) is a huge positive. Having said that 4 nodes show larger than a cm in length, three on the right (one may be the conjoined couple again though) and two on the left.  And I’m just confused about short axis diameter as I have one node measuring

1-1.07 cm
2-0.30cm
3-1.02 cm

That was the three dimensional measurement, is that concerning?

The others are as follows

RT neck

1.82cm by 0.35 cm by 0.91cm (this one may be the one which is two stuck together the ENT noticed, it seems like the tech always puts it as one)

0.59 cm by 0.22 cm by 0.36 cm

LT neck

1.38cm by 0.23 cm by 0.84 cm

0.44 cm by 0.18cm by 0.47 cm

0.96cm by 0.35cm by 0.53cm

1.08 cm by 0.16 cm by 0.30 cm

Now these were mostly all in the cervical chains only and the left neck is where they are palpable. Are any of these sizes terribly concerning? I always thought a short acid on a cm was bad but the one has two measurements at one cm?
5 Responses
Sort by: Helpful Oldest Newest
1081992 tn?1389903637
COMMUNITY LEADER
To make things a little more complicated, submandibular nodes tend to naturally rounded.

I've just been discussing with veryconfused about her doubled nodes, if you want to take a look at that thread. I'd suppose CT might see more sharply than US.

Helpful - 0
1081992 tn?1389903637
COMMUNITY LEADER
Well, it's too bad that the tech didn't have enough intellectual wondering to check out the double node. It is a curious thing, after all, and they might have learned something.
Helpful - 0
1 Comments
Yeah I’ve tried looking at the image myself but I can’t tell, only the lady ENT has said it looked like two overlapping (unless the spot I showed her wasn’t the two overlapping) but the ENT said it wasn’t concerning even if stuck together which I found odd, she said if they were stuck to skin or structure it would be though.

Also I do have a very small bump on my left collar bone way off towards the shoulder, it’s hard and not mobile but honestly feels like where a little segment of muscle wraps over the bone. Again I must say this is tiny and likely has always been that way. I can feel the little muscle or tendon wrapping over the other side but not as pronounced. ENT said it just felt like inflammation on the joint.
1081992 tn?1389903637
COMMUNITY LEADER
"I’m still confused on the 1.07cm by 0.30cm by 1.02 cm one, is the short axis there 1.02?"
Yes.

"a node of 1cm or just above or below can be the regular size isn’t that the case?"
Yes.

"Wouldn’t that make the node a pancake almost?"
Yes. Here is the general idea: the fatty hilum is at the edge of a node. That's the spot where the blood vessels go in and out, and also where the lymph vessel goes out, btw.

So if we envision a node as an oval, the short axis is measured from the hilum edge to the edge directly opposite.  The long axis would be perpendicular. When a node is reactive, it enlarges in a controlled way, mainly by growing outward in the long axis. But when a node is cancerous, it tends to grow willy nilly, and so on average it grows equally in all directions -- therefore it grows to being eventually rounded.

HOWEVER, a not-cancer node can sometimes grow to be rounded, it just happens. That's why the behavior and the internal architecture trumps the shape - unless the node was  very large like 3-4cm, then we'd have to investigate and account for why it is so big. Your 1cm is not near that, and even 2cm would still be okay. 3-4cm might be cancer, or might be filled with granulomas, or inflammatory pseudotumor IIRC.



Also, imagine a node with a new, still small cancer in it, in the left side. It would grow as a sphere, but still be growing on only one side of the node at first. So the node would be lopsided. That's why an asymmetrical node is bad. But yours are not asymmetrical, therefore that argues a lot that you do not have a new small cancer in a node.
Helpful - 0
1 Comments
I see, essentially the concern is the shortest measurement, so a perfect round node with each angle measuring 1.5cm or something would be considered more suspect etc as while my is kind of odd it still isn’t necessarily rounded given its overall shape still being well, not spherical in a 360 way
1081992 tn?1389903637
COMMUNITY LEADER
The size alone would be concerning if they were gigantic, but since they are not gigantic we interpret them according to behavior and architecture. So yes, they seem normal.

Since nodes are normally flat, then yes the shortest dimension of a 3D would be considered the height. So in:
1.08 cm by 0.16 cm by 0.30 cm  

the 0.30 cm would be the short axis.


If you ever have another US, I'd alert the tech about the 2-stuck-together so they use extra care and probably then verify that.

Helpful - 0
1 Comments
I mentioned the two stuck together but there’s no note of that in the report. Now from what I understand a node of 1cm or just above or below can be the regular size isn’t that the case? I’m just curious about the ‘closer to the skin’ comment and I’m still confused on the 1.07cm by 0.30cm by 1.02 cm one, is the short axis there 1.02? Or am I reading that wrong? Wouldn’t that make the node a pancake almost?
1081992 tn?1389903637
COMMUNITY LEADER
"concerning?"
No. Years ago the size was considered crucial, but no more.

Roundness is an indicator, but should not over rule behavior and internal architecture (seen via scan).

Helpful - 0
1 Comments
So are the sizes themselves good then? I know they say generally around a cm in length is mostly normal. On top of that would that one be consider one CM in short axis or not since one measurement is .30 cm (I am not good at understand the measurements of the 3D model
Have an Answer?

You are reading content posted in the Leukemia and Lymphoma Community

Top Leukemia & Lymphoma Answerers
1081992 tn?1389903637
PA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
An interview with the co-discoverer of one of the biggest breakthroughs in cancer research
From causes to treatment options, get answers to your questions about CML, a type of blood cancer
New drug options on the horizon may make CML, a type of blood cancer, one of the few success stories in cancer treatment
Herpes sores blister, then burst, scab and heal.
Herpes spreads by oral, vaginal and anal sex.
STIs are the most common cause of genital sores.