Table 3:

Locations and imaging appearance of cervical lymph node spreada

Lymph NodesNo. of Patients (%)
Location (n = 14)
    Level I8 (57)
    Level II13 (93)
    Level III7 (50)
    Level IV1 (7)
    Level V3 (21)
    Level VI0 (0)
    Level VII0 (0)
    RPN6 (43)
General appearance on CT (n = 14)
    Completely cystic (no solid areas on CT)0 (0)
    Predominantly cystic (<25% solid in appearance)1 (7)
    Moderately cystic (25%–49% solid)0 (0)
    Moderately solid (50%–74% solid)0 (0)
    Predominantly solid (75%–99%)4 (29)
    Completely solid (100% solid)9 (64)
Degree of contrast enhancement on CT (n = 14)
    None (no enhancing tissue visualized)0 (0)
    Mild (similar in density to normal lymph nodes)1 (7)
    Moderate (similar in density to glandular tissue)7 (50)
    Maximal (similar in density to vessels)6 (43)
FDG avidity (n = 12)
    Low3 (25)
    Medium5 (42)
    High4 (33)
  • a Metastases to level II lymph nodes occur in almost all patients with cervical disease. Levels I and III occur in >50% of patients, while RPNs are present in 43% of patients. On imaging, metastatic cervical lymph nodes are predominantly solid, with moderate-to-maximal contrast enhancement and medium-to-high FDG avidity.