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FIG 1 Case 1, a 79-year-old woman with squamous cell carcinoma of the left side of her tongue.
A, Non-contrast-enhanced CT image obtained at initial examination of a level I node (arrow); no hyperattenuation is evident.
B, First follow-up sonogram at the level I node obtained 1 month after surgery of the primary tumor (transverse section). Note an enlarged lymph node (arrow) with heterogeneous internal echo. MB indicates mandible.
C, Non-contrast-enhanced CT image at the level I node obtained 1 month after surgery of the primary tumor. Hyperattenuation entirely occupies the node (arrow). The size of the node has increased, and the minimal axial diameter of the node is 10 mm.
D, Contrast-enhanced CT image obtained at the same level and time as that of A. Hyperattenuation within the node (arrow) is obscured after the administration of contrast medium.
E, Photomicrograph (stain, hematoxyllin-eosin; original magnification, x2.5) shows the level I node is entirely replaced by the area of marked keratinization (arrows). The non-contrast-enhanced CT finding of hyperattenuation is likely correlated with this marked keratinization.
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