In the follow-up of patients surgically treated for melanoma, ultrasound (US) examination of the naturally draining lymphatic stations very often reveals lymph nodes that appear as irregular or atypical, without clear aspects of metastases. Based on these results, we can conclude that focusing excessively on such US findings could lead to the inappropriate performance of additional diagnostic tests, with a consequent increase in management costs and a worsening of the quality of life for these patients. Of the 124 patients, who were followed for at least one year, 42 showed these characteristics, and none of these showed any progression to malignancy at follow-up. We found a very high number of patients (42/124) with lymph nodes that did not appear to be fully normal at US examination, particularly those with structural alterations in the hilus and slight loss of physiologic curvature of the outlines, with moderate thickening of the cortex. A second US examination was performed on the same area after at least 12 months. The following parameters of the US performed on the lymph nodes were evaluated: number and size, aspects of the outline, including any extroflexion of the outline and contours morphology, homogeneity and thickness of the cortex and aspects of the hilus, characteristics of the vascularisation of the lymph node at color-power Doppler. The study population consisted of patients who presented consecutively to our facility for a control between 1 January 2009 and 30 July 2010 and who had undergone surgery for a melanoma, at least 6 months earlier, in areas draining to lymph nodes of the groin but choosing – for this study - the opposite side to the natural drainage. We evaluated such lesions among a cohort of patients. This may be a sign that there is a secondary cancer in the lymph nodes.Among patients undergoing follow-up after surgery for melanoma, ultrasound (US) very often reveals lymph nodes in groin area, that do not show clear characters of a metastatic lesion yet that have atypical US features, which could result in diagnostic uncertainty. Sometimes during a routine scan, a lymph node or a group of lymph nodes may look bigger than they should. But if you are worried, talk to your doctor or nurse. It is important to remember that lymph nodes can be swollen for other reasons, such as infections. Some people may also notice general symptoms of cancer, such as:Īlways see your doctor straight away if you have symptoms. If this happens in the arm or groin, it may cause a build-up of fluid that can cause swelling in the arm or leg. Sometimes cancer in the lymph nodes can block the flow of lymph fluid in that part of the body. If you have any of these symptoms, contact a doctor straight away. pain, redness or swelling in a leg or arm.This can cause the area to become swollen and can sometimes lead to a blood clot forming. If lymph nodes press on the blood vessels, they can slow the flow of blood through the vessels. For example, lymph nodes pressing on the lungs may cause breathlessness. But sometimes swollen lymph nodes may press on nearby organs or structures. If the swollen lymph nodes are deep inside the chest or tummy, the lymph nodes cannot be seen or felt. But if there are only a small number of cancer cells in the lymph nodes, you may not notice any changes. The most common symptom of cancer in the lymph nodes is that 1 or more lymph nodes become swollen or feel hard.

Groin lymph nodes