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The clinical assessment is helpful to approximate the localization or even to assign the nodule to a specific organ and assess its consistency and flexibility. A sonography is extremely helpful in most cases as you will find typical conclusions pertaining to the thyroid gland, results centered on lymph nodes, alterations in the tonsils, vessels and salivary glands. In some cases, the ultrasound should be supplemented by good needle puncture.CME Primary and Secondary Hyperchole