Tanaka T, Kamata M, Fukaya S, et al. - In this retrospective study, researchers assessed the benefit of real-time tissue elastography (RTE) for identifying lymph node metastases of skin cancer noninvasively before surgery. For this investigation, 21 lymph nodes from 12 patients with squamous cell carcinoma (SCC), 23 lymph nodes from 14 patients with malignant melanoma (MM), and 14 lymph nodes from 6 patients with extramammary Paget disease (Paget) were analyzed. According to results, lymph nodes evaluated as grade 3 or 4 by RTE were metastatic in all three skin cancers. It was noted that all lymph nodes assessed as grade 1 or 2 by RTE were reactive in SCC. On the other hand, some lymph nodes assessed as grade 1 or 2 were metastatic in MM and Paget. Findings suggested that RTE can help to distinguish reactive lymph nodes from metastatic ones, particularly in SCC.RTE can help to distinguish reactive lymph nodes, particularly in SCC, from metastatic nodes.