How can you tell the difference between lymph nodes and thyroid cancer since both are hypoechoic?

Biopsy: Well, the thyroid gland and lymphnodes are quite different and are located anatomically different as well. Some nearby nodes may be difficult to tell on ultrasound, but a biopsy sure can! good luck.

Training: The sonographer and the radiologist have extensive training to tell these different structures apart. If any question an ultrasound guided biopsy is relatively easy.

Biopsy: The two lesions have different appearances under the microscope. Removal of part of the lesion and examination by a pathologist usually settles the diagnosis.