To the Editor.—
Palpable but clinically unimportant lymph nodes are commonly described as "shotty," a word defined1 as "hard and round like a pellet of shot." However, American shot ranges in diameter from 1.25 mm for No. 12 to 9.14 mm for 000 buck-shot.2 A hard node almost 1 cm in diameter is clearly abnormal and usually requires a biopsy, while one 1.25 mm in size would be impalpable. It would be preferable to describe nodes using their diameters in centimeters, in addition to their consistency, mobility, and adherence to other nodes. If a node is too small to measure accurately and is considered clinically unimportant, it should be described as "tiny" rather than "shotty," a term so imprecise as to be meaningless.
Stolinsky DC. The Gauge of Nodes: Tiny to Buckshotty. JAMA. 1985;253(21):3092. doi:10.1001/jama.1985.03350450064015