Abstract
Ultrasound sonography (US) plays an important role in the assessment of lymph nodes in oncology. However, ultrasound findings are often equivocal in not allowing the differentiation of reactive from metastatic lymph nodes. Here, we present the successful use of contrast-enhanced US in the assessment of a metastatic lymph node, improving the performance of conventional US and optimising the US-guided percutaneous biopsy.
Highlights
A high-frequency probe (6–15 MHz) was placed on the right groin to visualise the largest area of the suspicious lymph node and was kept in a fixed position to visualise the dynamic phase, the contrast-enhanced US (CEUS) exam
The hypoperfused focal area within the lymph node was considered suspicious for metastatic deposit
The final histology confirmed the presence of a metastatic deposit in the suspicious lymph node (Figures 3 and 4), corresponding to the hypoperfused area visualised by CEUS
Summary
A 52-year-old patient who underwent a partial penectomy for a poorly differentiated squamous cell carcinoma (SCC) of the penis was followed up by ultrasound sonography (US) of the groin every four months. At the 16-month follow-up US, a normal-sized lymph node (15 × 7 mm2) in the right groin was considered suspicious because of its asymmetric shape due to a cortical bulging (Figure 1), suggesting a metastatic deposit. We decided to perform a contrast-enhanced US (CEUS).
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