Which finding is commonly associated with abnormal lymph nodes on ultrasound?

• A. Enlargement
• B. Irregular cortex
• C. Loss of fatty hilum
• D. Snowstorm effect

Answer: (A)

Enlargement is the most common sign of abnormal lymph nodes on ultrasound because swelling occurs readily with many processes that affect nodes, such as infection, inflammation, or metastasis. Lymph nodes normally have an ovoid shape with a hypoechoic cortex and a central echogenic fatty hilum. When something irritates or invades a node, it tends to grow first, making it easier to detect on imaging. While features like an irregular cortex or loss of the fatty hilum can indicate pathology, they are not as universally present as enlargement and are more specific to certain conditions (for example, malignancy may show hilum effacement and cortical irregularity). The snowstorm appearance doesn’t describe nodal pathology on ultrasound and isn’t a typical finding for abnormal lymph nodes.