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. 2017 Jul 27;7:6670. doi: 10.1038/s41598-017-07118-7

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© The Author(s) 2017

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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PTC with cervical LNM. A hypoechoic nodule with ill-defined margin, irregular shape and some microcalcifications was found at the lower pole of the right thyroid lobe in a 34- year– old female patient (A). The thyroid focal posterior capsular was bulged by nodule. The size of nodule was 1.6 cm × 1.5 cm × 1.0 cm. CEUS showed that a heterogeneous low-enhancement in nodule (left image) and its area (1.8 cm × 1.6 cm × 1.2 cm) was larger than the nodule region displayed on grey-scale image (right image) (arrow). Both the anterior and posterior thyroid capsular were broken and invaded by the nodule (arrows) (B). Intense expression (+++) (arrow) of matrix metalloproteinase-9 was found in the cytoplasm of the malignant cells of a PTC sample, as shown by the brown staining (magnification, ×200) (C). Surgical results: PTC with ipsilateral region III-V and central compartment region LNM.