Which feature of a lymph node is commonly associated with abnormal nodes?

• A. Cortical thickening with loss of fatty hilum
• B. Uniform echotexture with preserved hilum
• C. Very small size with a thin cortex
• D. Homogeneous internal vascularity with a visible hilum

Answer: (A)

Abnormal lymph nodes on ultrasound commonly show cortical thickening with loss of the fatty hilum. In a healthy node, the cortex is thin, the central fatty hilum is visible, and the echotexture is relatively uniform. When pathology develops, the cortex thickens and the fatty hilum becomes indistinct or disappears as the node is infiltrated or expanded by abnormal tissue. This cortical enlargement with hilum effacement is a classic sign suggesting abnormal or potentially malignant involvement.

The other patterns described fit normal or benign appearances: a node with uniform echotexture and preserved hilum is typical of a normal or benign reactive node; very small size with a thin cortex also indicates a normal node; homogeneous internal vascularity with a visible hilum suggests a normal vascular pattern and preserved hilum. In malignancy, you’d expect cortical thickening with hilum loss and often peripheral or abnormal vascularity, not a uniformly preserved hilum with homogeneous flow.