Imaging of head and neck lymph nodes

Lymph nodes are vital components of the immune system and are numerous in the neck. They are ovoid structures surrounded by a capsule that are fed by afferent lymphatic vessels transporting lymphatic fluid from the soft tissues. The substance of the lymph node contains immune cells and immune mediators, in effect filtering the lymphatic fluid, which exits at the nodal hilum in the efferent lymphatic channel; this channel runs parallel to a vascular pedicle that contains an artery and vein.

Lymph nodes can become pathological secondary to infection, inflammation and neoplastic processes that spread via the lymphatic fluid, both primary disease in the case of lymphoma and some leukaemias, and secondarily when malignant disease spreads into the lymphatic system and manifests as metastases to lymph nodes.

Imaging has a crucial role in characterising lymph nodes as normal or pathological. Further than this, imaging can facilitate cellular or tissue sampling to enable definitive pathological characterisation.

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