الفهرس 
Histological pattern of lymph nodesOnly 14 pages are availabe for public view
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Abstract
The pathological status of axillary lymph nodes is a useful prognostic factor in women with breast cancer , so this study aims to evaluate how far we can depend on lymph node examination with color Doppler as an adjuvant in staging of malignancy, and in differentiation benign from malignant breast lesion depending upon certain criteria of the enlarged axillary lymph nodes . This study included 37 females complaining of symptoms related to breast lesions, their age ranged from 34 to 61 years with the mean age of 47 years . All cases were subjected to clinical examination, then they underwent 2D ultrasonographic examination of the breast and axilla, followed by color Doppler examination of the axillary lymph nodes using the same ultrasonographic equipment . * 9 patients were suffering from breast abscess . * 9 patient suffer from infiltrating duct carcinoma * 5 patient suffer from fibroadenoma *4 patient suffer from infiltrating lobular carcinoma *4 patient suffer from colloid carcinoma *4 patient suffer from papillary carcinoma *2 patient suffer from undifferentiated carcinoma from our study we find that, there is certain criteria that could be helpful to distinguish benign from malignant lesion, these criteria includes distortion of the shape of lymph node as normally the longitudinal diameter is greater than the transverse diameter, but this is lost in malignant infiltration as the node becomes nearly rounded or irregular in shape with destructed hilum and loss of differentiation between cortex and medulla . Also, the resistive index and pulsatility index are relatively increased in malignant lymph nodes than in benign ones . The great advance in color Doppler in the last decade made it more beneficial in lymph node examination, and to add certain sign that would be suggestive for malignancy when present during examination, as regard the vascularity of the node there will be hypervascularity in both benign and malignant nodes, but in inflammatory diseases there is vasodilatation leading to decreased resistance to blood flow and decreasing resistive index. While in malignant nodal infiltration, the vessels are compressed by tumor cells resulting in increased resistance to blood flow and increasing resistive index . The intranodal angio architecture is a reliable aid in the differentiating benign and malignant lyphadenopathy, reactive nodes tend to involve a diffuse histological process and are more likely to preserve normal vascularity pattern with central hilar vessels, while malignant changes caused by infiltrating tumor cells leads to distortion and destruction of the pre existing nodal vascular pattern . The contribution of color Doppler and grey scale US to differentiate diseased axillary lymph nodes in women with breast lump is specially pertinent given the current interest in seeking method other than axillary dissection or sampling for staging and treating breast cancer, with promising findings that may have clinical applicability and could be used to identify nodes that merit imaging guided biopsy. Color Doppler examination of axillary lymph nodes could be used as a reliable method for follow up of axillary nodal diseases with the current shift towards neoadjuvant medical and hormonal therapy for breast cancer.