Which ultrasound finding is characteristic of silicone lymphadenopathy?

• A. Snowstorm appearance
• B. Anechoic ring
• C. Posterior shadowing only
• D. Ring-down artifact

Answer: (A)

The key idea is recognizing the ultrasound hallmark of silicone in lymph nodes. Silicone lymphadenopathy shows a snowstorm pattern: many tiny, highly echogenic foci scattered throughout the node with posterior acoustic shadowing, creating a hazy, speckled appearance rather than a discrete mass or a simple cyst. This appearance stems from dispersed silicone droplets within the tissue, which strongly scatter ultrasound waves and produce that characteristic granular, glitter-like look.

Other patterns don’t fit because an anechoic ring would suggest a simple cystic structure, not silicone droplets; posterior shadowing alone doesn’t capture the diffuse, speckled echogenicity produced by multiple microdroplets; and ring-down artifact is not a typical feature of silicone in lymph nodes.