Sonographic localisation and description of inguinofemoral lymph nodes in patients with vulvar squamous cell carcinoma

Sonographic imaging of the inguinofemoral lymph nodes can be performed in patients with vulvar cancer to discriminate between normal (benign and reactive) and malignant appearing lymph nodes. A systematic sonographic protocol for imaging inguinofemoral lymph nodes is not commonly used, but could aid in homogenising the reporting of lymph node location and status. This paper unpacks the relative anatomy of the inguinofemoral lymph nodes. A protocol outlining the sonographic assessment of inguinofemoral lymph nodes and the criteria to use to guide the reporting of their size, shape, echogenicity and vascular architecture is discussed.