![]() In addition, NLPHL is typically negative for Epstein–Barr virus (EBV). This lymphoma was considered to be analogous to “low-grade” B-cell lymphomas, but disseminated disease is not usually observed. NLPHL tends to spare the mediastinum, spleen, or bone marrow. Most patients present with localized peripheral lymphadenopathy, which develops slowly and is responsive to therapy. In adults, median age of onset is 30–35 years. This disease is a predominately male disease with a 3:1 ratio of male to female in Caucasian and a 1.2:1 ratio in African individuals. NLPHL consists of 5% of all reported cases of Hodgkin lymphoma. Amitava Dasgupta PhD, in Hematology and Coagulation (Second Edition), 2020 Nodular lymphocyte predominant Hodgkin lymphoma The term posterior cervical nodes is nonspecific, referring to nodes of the spinal accessory chain and those of the superficial cervical chain that lie over and behind the SCM muscle lymph nodes anterior to the SCM muscle are designated as in the anterior triangle and those behind as in the posterior triangle.Īmer Wahed MD. The superficial anterior chain runs in the midline from the chin to the suprasternal notch and comprises, in descending order, the infrahyoid, prelaryngeal, pretracheal, and anterior cervical nodes. The superficial cervical chain follows the external jugular vein, which runs obliquely across the surface of the SCM muscle to empty into the subclavian vein in the supraclavicular triangle. The deep lateral or spinal accessory chain runs behind the posterior border of the sternocleidomastoid (SCM) muscle and along the spinal accessory nerve. The superficial cervical nodes in the neck are a disparate group composed roughly of three vertical chains. Thorell, in Principles and Practice of Pediatric Infectious Diseases (Fifth Edition), 2018 Superficial Cervical Nodes Retropharyngeal (RPS) nodal group: Medial RPS nodes and lateral RPS nodes (Rouvière node) ○Įmily A. Parotid nodal group: Intraglandular or extraglandular ○ Other nodal groups not included in standard imaging-based nodal classification ○ Includes prelaryngeal, pretracheal, and paratracheal subgroups ○īetween carotid arteries from top of manubrium above to innominate vein below Level VB: Lower SAC nodes from cricoid to clavicle ○įound from hyoid bone above to top of manubrium below – Level VA: Upper SAC nodes from skull base to bottom of cricoid cartilage – SAC nodes lie posterior to back margin of sternocleidomastoid muscle – Level V: Nodes of posterior cervical space/spinal accessory chain – Level IIB: Level II node posterior to IJV with fat plane visible between node and IJV ○įrom hyoid bone to inferior margin of cricoid cartilage ○įrom inferior cricoid margin to clavicle ○ Level IIA: Level II node anterior, medial, lateral or posterior to IJV if posterior to IJV, node must be inseparable from IJV contains jugulodigastric nodal group – Level II: Upper IJC nodes: From posterior belly of digastric muscle to hyoid bone – Level IB: Submandibular nodes: Found around submandibular glands in submandibular space ○ Level IA: Submental nodes: Found between anterior bellies of digastric muscles – Level I: Submental and submandibular nodes – Hilar vascularity on color/power Doppler examination Homogeneous, hypoechoic cortex with echogenic hilum ○ ![]() Small, oval/reniform shape with well-defined margin ○ US appearances of normal cervical lymph node ○ Internal structures: Capsule, cortex, medulla, hilum In normal adult neck, may be up to 300 lymph nodes ○
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