FIG 2. Follow-up sonogram of lymph node in patient 2. A, The first follow-up sonogram. The lymph node measures 3 mm in short-axis diameter. B, The second follow-up sonogram (28 days after the first follow-up sonogram was obtained). Short-axis diameter of the lymph node has increased by 2 mm. Slight, internal echogenicity, suspicious for metastasis, is visible. C, The third follow-up sonogram (9 days after the second follow-up sonogram was obtained). Short-axis diameter of the lymph node has increased by 1 mm. Marked internal echogenicity is increased, and the boundary of the node is unclear, suggesting extranodal extension of disease. Pathologic examination of this lymph node confirmed metastasis, with extranodal extension of disease.