CASE 131: LEFT SUPRACLAVICULAR NODES, PELVIC TUMOR AND MESENTERIC NODES, Dr PHAN THANH HẢI, MEDIC, MEDICAL CENTER, HCMC, VIETNAM

Woman 36 yo, one month after operation by pelvic abscess, she detected her neck swollen on the left site. Ultrasound the neck and abdomen.

Many lymph nodes were at the left supraclavicular area (Troisier's node), one big and many small hypoechoic around.

 

 
Doppler CDI can see the hilus of the lymph node, and thyroid gland was normal.

At left iliac fossa, ultrasound scan detected the elliptical structure, CDI showed  that the lymph node at mesenteria like sandwich sign.

 
DISCUSSION:
Sandwich sign  in ultrasound  is the same as finding  made by MDCT in  hypertrophy of the lymph node   with the vessel inside this mass.

Ultrasound is the best for diagnosis of  the scenario including very poor echostructure  like cyst  of  LYMPHOMA.

Biopsy of course  is the final  report with histo-chemistry staining.