INTRODUCTION: The aim of this study was to retrospectively analyse the ultrasound findings in the axillary lymph nodes in breast cancer patients with morphological changes that required biopsy. In most cases the morphological changes were minimal. MATERIALS AND METHODS: Between January 2014 and September 2019 examination of axillary lymph nodes with subsequent core-biopsy was performed in 185 breast cancer patients at the Department of Radiology. Lymph node metastases were detected in 145 cases, while in the remaining 40 cases benign changes or normal lymph node (LN) histology was observed. Ultrasound morphological characteristics and the sensitivity and specificity were evaluated retrospectively. Seven ultrasound characteristics were evaluated - diffuse cortical thickening, focal cortical thickening, absence of the hilum, cortical non-homogeneities, L/T ratio (longitudinal to transverse axis), type of vascularization and perinodal oedema. RESULTS AND CONCLUSION: It is a diagnostic challenge to recognize metastases in the lymph nodes with minimal morphological changes. The most specific signs are non-homogeneities in the cortex of the lymph node as well as the absence of fat hilum and perinodal oedema. Metastases are significantly more frequent in LNs with a lower L/T ratio, in LNs with perinodal oedema and with a peripheral type of vascularization. Biopsy of these lymph nodes is necessary to confirm or exclude metastases, especially if it affects the type of treatment.

• Klíčová slova
• breast cancer, lymph node, metastases, ultrasound,
• MeSH
• axila MeSH
• lidé MeSH
• lymfatické metastázy * diagnostické zobrazování   patologie   MeSH
• lymfatické uzliny * krevní zásobení   diagnostické zobrazování   patologie   MeSH
• nádory prsu * diagnostické zobrazování   patologie   MeSH
• patologická angiogeneze diagnostické zobrazování   patologie   MeSH
• prediktivní hodnota testů MeSH
• retrospektivní studie MeSH
• senzitivita a specificita MeSH
• ultrasonografie * metody   statistika a číselné údaje   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH

OBJECTIVES: The aim of this study is to evaluate accidental findings of axillary lymphadenopathy during breast examination. Postvaccination axillary lymphadenopathy is a possible cause of adenopathies but these findings used to be exceedingly rare. Nowadays, after Covid-19 vaccination it is found more often. Covid-19 vaccination started at the end of December 2020 with two types of vaccine, Moderna and Pfizer-BioNTech in the Czech Republic. The aim of this article is to present a single centre experience with Covid-19 lymphadenopathy during the general vaccination in the Czech population and summarization of recommendations. METHODS: In January to February 2021 ultrasound revealed axillary lymphadenopathy in several patients during breast examination in our certified centre. In four of them it was concluded as lymphadenopathy after Covid-19 vaccination. A search (using databases PubMed and Google Scholar) of the available literature for the years 2020 and 2021 was performed. RESULTS: These four patients were examined during the first two months of 2021. In all of them pathological lymph nodes with typical sonographic signs were seen in the ipsilateral axilla. We searched the literature for follow-up recommendations and summarized them in our article. CONCLUSION: Accidental findings of axillary lymphadenopathy during ultrasound breast examination will be more often. There will be more cases of lymphadenopathy with an increasing number of people being vaccinated against Covid-19.

• Klíčová slova
• Covid-19, axilla, lymph node, lymphadenopathy, ultrasonography, vaccination,
• MeSH
• COVID-19 * prevence a kontrola   MeSH
• lidé MeSH
• lymfadenopatie * diagnóza   etiologie   MeSH
• vakcinace MeSH
• vakcíny proti COVID-19 * škodlivé účinky   MeSH
• výzkum MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• vakcíny proti COVID-19 * MeSH

AIM: The aim of this retrospective study was to analyse the preoperative ultrasound findings in patients with minimal or almost no morphological changes of axillary lymph nodes (LN) and to correlate these findings with the results of sentinel node (SN) biopsy. MATERIALS AND METHODS: Between January 2014 and September 2018, 289 female patients with newly diagnosed breast cancer and negative preoperative axillary staging were examined with preoperative ultrasound evaluation of axillary LNs. Patients with no evidence of LN metastases underwent primary surgical treatment with SN biopsy. Negative predictive value (NPV) of preoperative ultrasound was evaluated and the histopathological findings in positive SN biopsies were correlated with tumour type and preoperative ultrasound LN imaging. RESULTS: Of 289 patients with negative preoperative axillary staging who had primary surgical treatment, 268 patients had negative SN biopsy while SN metastases were detected in 21 patients. Of patients with positive SN biopsies, 2 patients had negative core biopsy of axillary LN before surgery. The preoperative ultrasound examination was negative in the remaining 19 patients with SN metastases. CONCLUSIONS: Preoperative ultrasonography is very accurate in the detecting of axillary LN metastases. Patients with primary tumour size ≥ 1 cm, with grade ≥ 2 no special type carcinomas (NST - no special type, also known as invasive ductal carcinoma) or multicentric lobular invasive cancer should undergo a more thorough ultrasound evaluation.

• Klíčová slova
• axillary staging, breast cancer, sentinel node biopsy, ultrasound,
• MeSH
• axila MeSH
• biopsie sentinelové lymfatické uzliny * MeSH
• lidé MeSH
• nádory prsu patologie   chirurgie   MeSH
• předoperační období MeSH
• retrospektivní studie MeSH
• staging nádorů MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Fine-needle biopsy of the thyroid gland is the most common interventional procedure used to diagnose thyroid diseases. Serious complications are rare in this procedure. They comprise an infection with abscess formation and hemorrhage. To date, only a few case reports have described an ultrasound diagnosis of active bleeding into the thyroid gland. We established such a diagnosis using computed tomography (CT). PATIENT FINDINGS: A 74-year-old woman presented to the emergency department of our hospital with complications after fine-needle biopsy of the thyroid gland. Ultrasound revealed a large hematoma surrounding the gland. A subsequent CT scan confirmed the presence of hematoma and, moreover, showed active bleeding. This finding prompted rapid surgical intervention. CONCLUSION: CT has the capability to show active bleeding into the thyroid gland.

• MeSH
• biopsie tenkou jehlou pod endosonografickou kontrolou škodlivé účinky   MeSH
• bolest krku etiologie   MeSH
• hematom diagnostické zobrazování   etiologie   chirurgie   MeSH
• lidé MeSH
• nemoci štítné žlázy diagnostické zobrazování   etiologie   chirurgie   MeSH
• počítačová rentgenová tomografie MeSH
• pooperační krvácení diagnostické zobrazování   etiologie   chirurgie   MeSH
• senioři MeSH
• štítná žláza diagnostické zobrazování   zranění   patologie   chirurgie   MeSH
• urgentní služby nemocnice MeSH
• uzlová struma diagnóza   patologie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH