Differential Diagnosis of Cervical Lymph Nodes with Ultrasound and Virtual Touch Imaging Quantification: a Report of Three Cases.

Cervical lymphadenopathy is a common clinical presentation, and its differential diagnosis is challenging. In this article we present three cases with enlarged cervical lymph nodes evaluated with combination of ultrasound (US) and virtual touch imaging quantification (VTIQ) performed by the head and neck surgeon G.P. with a 10-year experience in ultrasound elastography (USE). In the first two cases, US and VTIQ evaluation showed predominance of areas with increased stiffness and higher share wave velocities compared with those in the third case. Malignancy was suspected in the first and second cases. The histology report revealed metastatic squamous cell carcinoma in the first two cases and chronic non-specific lymphadenopathy in the third case. The development of VTIQ share wave elastography has improved the diagnostic accuracy of ultrasonography and can guide clinical decision when dealing with cervical lymphadenopathy.