BH: a 30-year-old female complained of a palpable mass in the right breast. A cystic lesion was identified in the previous US. At the time of the US, the FNA radiologist noticed thickening in the wall surrounding the cyst that was 26 mm × 14 mm in size. First, the cyst was aspirated, and 3 cc of partially thick cystic fluid was obtained. Consequently, a sample in the form of “bird-pecking” was taken from the cystic wall. Cytologic diagnosis: (i) Cystic fluid: cystic macrophages were observed in a partially dirty inflamed background. (ii) Wall samples: malignant ductal epithelial groups were observed []. Histopathology: Infiltrating ductal carcinoma.\nTHM: sampling not only from the cyst but also from the wall enabled the detection of the malignancy.[]
BH: A 72-year-old female presented with a mass in the neck that had been present for 1 month. A 35 mm × 20 mm LN was observed in the left submandibular region during US, while 24 mm × 16 mm and 26 mm × 15 mm nodules were observed in the right thyroid isthmus and the left lobe, respectively. Clinical prediagnosis included lymphoma and metastasis; US-FNA was performed on all three lesions. Cytologic findings: LN: high numbers of pleomorphic, multinuclear, bizarre and undifferentiated cells were noted in the left submandibular mass []. Thyroid nodules: The findings were compatible with “adenomatous nodule” (FNA was performed in the same session to exclude thyroid malignancy). Cytologic diagnosis of the submandibular mass was “undifferentiated pleomorphic malignant tumor.” Histoimmunopathology: Anaplastic large cell lymphoma. THM: The detection of many multinuclear, large, “bizarre” cells led us to consider the presence of three lesions during the differential diagnosis: Anaplastic large cell lymphoma, melanoma and anaplastic carcinoma/sarcoma.