Lymph node metastasis (CEUS)
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Cervical node swelling. No relevant diseases in her medical history.
B MODE; COLOR AND POWER DOPPLER AND CEUS OF CERVICAL NODE
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B mode cervical ultrasound shows lymph node with displaced hilum and nodular thickening of the cortex, suggesting metastatic involvement. Other enlarged cervical nodes were seen (not shown).
Power Doppler shows displaced vascular hilum and scarce or no vascularity in the thickened area.
Contrast-enhanced ultrasound (CEUS) shows normal enhancement of the normal part of the lymph node (star) and very scarce and partial enhancement of the nodular part (m), suggestive of metastatic involvement.
Clinically the patient was suspect of inflammatory cervical node enlargement according to her age and lack of relevant history. Cervical nodes were worrisome in the B-mode US, with nodular thickening of the cortex, displaced hilum and displaced hilar vessels on color Doppler US. CEUS finding of nodular almost non-enhancing areas made the possibility of metastatic involvement seem very probable. Fine needle aspiration of the node and CT scan showed metastatic lung adenocarcinoma.