 Endoscopic ultrasound EUS is an important part of the pre-treatment evaluation of patients with upper gastrointestinal tract cancer esophageal, gastric, pancreatic and liver cancer. When planning the optimal therapy in patients with upper gastrointestinal malignancies it is essential to know the exact lymph node stage. Recently endoscopic sonoelastographyES has been added to conventional EUS examination and may provide complementary information to distinguish benign for malignant lymph nodes. 