Misleading appearance in cervical lymph node US diagnosis – a report on sarcoidosis, Warthin tumor and squamous cell carcinoma metastases

Abstract

Ultrasonography, with its various techniques (grey-scale, color Doppler, sonoelastography) offers many signs for the differentiation between benign and malignant neck lymph nodes. In spite of recent progress, the US appearance may be misleading. We present three cases in which the ultrasonographic appearance of the lymph nodes was misleading as compared to the final diagnosis established by histopathology.

Endoscopic ultrasound elastography to diagnose sarcoidosis

“…[ 4 ] Another case of a cervical lymph node had features highly suspicious for malignancy with a predominant blue pattern on EUS elastography; however, the pathology was consistent with sarcoidosis. [ 5 ] In contrast, our case showed a mixed, predominantly green pattern, which is more consistent with benign tissue being sarcoidosis. An elastographic score of 3 is consistent with a mixed pattern of hard and soft tissues “honeycombed pattern,” which may make the interpretation difficult.…”