63-year-old female with history of lymphoma with PET avid lymph node remaining in the right axilla, presenting for targeted right axillary ultrasound. Evaluate ability to biopsy or place a wire. On physical examination, no palpable mass/lymph nodes were identified in the right axilla.A targeted right axillary ultrasound was performed. In the right axilla there is a borderline lymph node with slightly thickened cortex as compared to the other adjacent lymph nodes with fatty hila. It is located within the deep axilla measuring 9 mm x 7 mm by 11 mm and demonstrates normal morphology with hilar flow present on Doppler imaging. This likely corresponds to the FDG avid lymph node on recent PET scan and is located adjacent to blood vessels. There are additional smaller benign morphology lymph nodes elsewhere in the right axilla.
Borderline right axillary lymph node located in the deep axilla adjacent to a blood vessel. This likely corresponds to the FDG avid lymph node on recent PET scan. Based on location and size, a biopsy of this lymph node would be technically challenging. However needle localization of this lymph node with wire placement can be performed if an excisional biopsy is considered. Findings were discussed with Dr. Jaskowiak's team on 7/14/2016 at 4:40 PM. BIRADS: 4 - Suspicious Abnormality.RECOMMENDATION: B - Surgical Consultation.