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Detection of Pelvic Lymph Node Metastases in Gynecologic Malignancy

A Comparison of CT, MR Imaging, and Positron Emission Tomography

A. D. Williams1, C. Cousins1, W. P. Soutter2, M. Mubashar1, A. M. Peters1, R. Dina3, F. Fuchsel1, G. A. McIndoe2 and N. M. deSouza1

1 Department of Imaging, Hammersmith Hospital, Imperial College School of Medicine, Du Cane Rd., London W12 0HS, United Kingdom.
2 Department of Gynecological Oncology, Hammersmith Hospital, Imperial College School of Medicine, London W12 0HS, United Kingdom.
3 Department of Histopathology, Hammersmith Hospital, Imperial College School of Medicine, London W12 0HS, United Kingdom.



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  		Fig. 1A. —33-year-old woman with endometrial cancer and histologically confirmed lymph node metastases. Transverse CT scan through pelvis shows enlarged lymph node (arrow) in right iliac region above level of common iliac bifurcation.

 


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  		Fig. 1B. —33-year-old woman with endometrial cancer and histologically confirmed lymph node metastases. Coronal spin-echo T1-weighted MR image (TR/TE, 720/20) shows bilateral enlarged lymph nodes (arrows).

 


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  		Fig. 1C. —33-year-old woman with endometrial cancer and histologically confirmed lymph node metastases. Coronal positron emission tomography scan shows foci of increased uptake in both iliac chains (black arrow) and in left supraclavicular region (white arrow).

 


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  		Fig. 2A. —26-year-old woman with clinical stage I cervical cancer and histology negative for tumor. Coronal spin-echo T1-weighted MR image (TR/TE, 720/20) through mid pelvis shows enlarged lower iliac node on right (arrow).

 


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  		Fig. 2B. —26-year-old woman with clinical stage I cervical cancer and histology negative for tumor. Coronal short tau inversion recovery MR image (TR/TE, 2500/30; inversion time, 107 msec) through mid pelvis, at same level as A, shows enlarged lower iliac node on right (arrow).

 


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  		Fig. 3. —Coronal positron emission tomography scan of 42-year-old woman with cervical cancer shows focus of increased uptake in left lower iliac region (arrow). Histology of lymph nodes was negative for tumor.

 


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  		Fig. 4. —Photomicrograph of microscopic deposit in lymph node (arrow) of 62-year-old woman with cervical cancer shows overall length to be 14.5 cm. (H and E, x5)

 


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  		Fig. 5. —Photomicrograph of lymph node in 33-year-old woman with endometrial cancer shows node largely replaced by tumor. Overall length is 8.0 cm. (H and E, x5)

 

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