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Historically, the lymph nodes in the neck have been anatomically divided into at least six neck lymph node levels for head and neck cancer staging and therapy-planning purposes. Differing definitions exist across specialties 1-4 .
The size of cervical lymph nodes varies by location and gender, and lymph nodes in the upper neck, including the submandibular and level II, are larger than other locations. There is no uniform standard for the threshold for differentiating benign and malignant lymph nodes.
Ultrasound imaging is an invaluable tool for evaluating lymph nodes, helping radiologists to distinguish between normal and abnormal nodes based on their size, shape, texture, and other characteristics.
There are approximately 600 lymph nodes, of which only some are available to direct palpation. Only some nodes (including neck, axilla and groin) should ever be normally palpable, and when they are, they should be soft and non-tender.
Normal size of cervical nodes varies from 0.3 to 0.8 cm. Lymph nodes in the upper neck, specifically submandibular and upper cervical nodes, tend to be larger. A classification system of lymph nodes has been established to simplify ultrasound evaluation of the neck into eight regions ( Figure 33.3 ).
This level contains the parotid node group, which includes the subcutaneous pre-auricular nodes, the superficial and deep intraparotid nodes and the subparotid nodes. These nodes extend from the zygomatic arch and the external auditory canal down to the mandible.
The cervical lymph nodes are la arge group of lymph nodes that drain the neck region and associated structures. Learn about their anatomy now on Kenhub!
Axial sections through lymph nodes of different shapes. Dotted line represents the maximum axial diameter; solid line with arrowheads is the minimum axial diameter.
The lymph node exam should always be performed in certain situations. Learn the important aspects of this exam.
In this article, we present a 4-step approach to evaluating lymph nodes in the setting of head and neck squamous cell and thyroid carcinoma and highlight important tips and traps.