fig 3.

Follow-up sonograms of the lymph node in patient 5. A, The third follow-up sonogram. The lymph node measures 5 mm in short-axis diameter, with normal hilar echoes (arrow). B, The fourth follow-up sonogram (35 days after the third follow-up sonogram was obtained). The size of the lymph node has not changed, and normal hilar echoes are also observed. In retrospect, we should have noticed that the hilar echoes were slightly less distinct compared with those revealed by the last sonogram (arrow), and should have performed sonography at a shorter interval after performing the third follow-up examination. C, The fifth follow-up sonogram (42 days after the fourth follow-up sonogram was obtained). The lymph node has increased by 5 mm in short-axis diameter. Internal echogenicity is also observed, and the normal hilar echoes are no longer visible. Pathologic anlaysis of this lymph node confirmed metastasis with extranodal extension of disease.