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Fig. 5E. —Gray-scale sonograms of patients with metastatic nodes. Image of 44-year-old woman with papillary carcinoma of thyroid and associated metastatic node in right upper cervical region shows metastatic node appears hyperechoic (arrowheads) when compared with adjacent muscle and has intranodal punctate calcification (arrow). These sonographic features are common in metastatic nodes from papillary carcinoma of thyroid.