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.