Fig. 1

A NUS showed right supraclavicular lymphadenopathy, and the target lymph node was hypoechoic, uniform, no lymph hilum, clear border and no fusion. B CEUS showed that the target lymph node showed uniform and high enhancement and there was no non-enhanced area at the peak. C Pathological specimens obtained by ultrasound-guided percutaneous biopsy showed granuloma. (Case1, a 34-year-old male). D NUS showed right supraclavicular lymph node was enlarged, and the target lymph node was hypoechoic, non-uniform, no lymph hilum, clear border and no fusion. E CEUS showed that the target lymph node showed non-uniform and high enhancement, and there were large irregular areas without enhancement at the peak. F Pathological specimens obtained by ultrasound-guided percutaneous biopsy showed necrotizing granuloma. (Case2, a 22-year-old male). G NUS showed right supraclavicular lymph node was enlarged, and the target lymph node was hypoechoic, uniform, no lymphatic hilum, clear border and no fusion. H CEUS showed that the target lymph node showed uniform and equal enhancement, and there was no non-enhanced area at the peak. I Pathological specimens obtained by ultrasound-guided percutaneous biopsy showed granulomatous lesions, no necrosis, acid-fast found a small number of positive bacilli, considering the possibility of tuberculous lesions. (Case3, a 49-year-old female). J NUS showed right supraclavicular lymph node was enlarged, and the target lymph node was hypoechoic, uniform, no lymphatic hilum, clear border and no fusion. K CEUS showed that the target lymph node showed uniform and high enhancement, and there was no non-enhanced area at the peak. L Pathological specimens obtained by ultrasound-guided percutaneous biopsy showed metastatic non-small cell carcinoma, tending to adenocarcinoma. (Case4, a 65-year-old male). M NUS showed right supraclavicular lymph node was enlarged, and the target lymph node was hypoechoic, uniform, no lymphatic hilum, clear border and no fusion. N CEUS showed that the target lymph node showed non-uniform and high enhancement, and there were small irregular non-enhanced areas at the peak. O Pathological specimens obtained by ultrasound-guided percutaneous biopsy showed metastatic small cell carcinoma. (Case5, a 78-year-old male). P NUS showed right supraclavicular lymph node was enlarged, and the target lymph node was hypoechoic, non-uniform, lymphatic hilum, clear border and no fusion. Q CEUS showed that the target lymph node showed uniform and high enhancement, and there was no non-enhanced area at the peak. R Pathological specimens obtained by ultrasound-guided percutaneous biopsy showed lymphoid tissue hyperplasia (Case6, a 60-year-old male). Hematoxylin–eosin stain was used for histopathology and magnification × 100