PMC6882555_01
High digestive endoscopy and echoendoscopy. (A and B) Lateral wall bulging of esophagus wall, with elevated fusiform injury and erosion; (C) Echoguided puncture of mediastinal lymph node; (D) Hypoechogenic lymph node, heterogenous, with hyperechogenic center, and hypervascularization showed in Doppler ultrasound (high flow) measuring around 15mm; (E) Qualitative elastography with soft characteristics (green-like)
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Some lymph nodes had contiguity with esophagus wall (Figure 1).
PMC6882555_02
Subcarinal lymph node. (A) Reconstruction of chest tomography in axial, coronal and sagittal cuts, with increased subcarinal lymph node (white arrow); (B) Hypoechogenic lymph node, homogenous, with hyperechogenic, measuring around 30mm; (C) Qualitative elastography with benign characteristic (green axis); (D) Echoguided puncture
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Qualitative elastography showed soft consistence (Figure 2).
PMC6882555_03
Paratracheal lymph node. (A) positron tomography emission imaging with left paratracheal lymph node (SUV 5.5); (B) Reconstruction in chest tomography in axial and coronal cuts, with increased lymph nodes (white arrow); (C) Endoscopic ultrasound showed hypoechogenic, homogenous lymph node measuring around 25mm; (D) Qualitative elastography with intermediary rigidity characteristics (blue and green); (E) Echoguided puncture
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We conducted PAAF of 22G (Figure 3).
PMC6882555_04
Mediastinal enlargement. (A) Chest radiograph; (B) Reconstruction of chest tomography in axial, coronal and sagittal cuts, with increased lymph nodes (white arrows); (C) Endoscopic ultrasound showed hypoechogenic, homogenous, lymph nodes measuring around 25mm; (D) Qualitative elastography with benign characteristics (green-like)
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Echoguided punctures were conducted (Figure 4).