BH: an FNA was requested for a 45-year-old female patient with multiple sclerosis due to the presence of an LN in the neck. Multiple LNs, the largest of which was 3 cm, were detected during the US. A US-FNA was performed on the dominant LN located in the left cervical region. Cytologic findings: homogenously spread monomorphic, large, round, atypical lymphoid cells were detected []. Cytologic diagnosis: Non-Hodgkin's lymphoma. Surgical biopsy and afterward: The biopsy from the neck was reported to be a “sebaceous cyst.” I wrote a letter to her physician and emphasized that there were bilateral multiple LNs in the neck and that the FNA picture did not reflect a “sebaceous cyst” at all. I called the patient 5 months later. After receiving my note, her physician excised the LN on which I had performed the FNA. The patient was diagnosed with “diffuse large B-cell lymphoma” and received treatment. It turned out that the mass described as a “sebaceous cyst” was removed by the physician, as it was easy to remove from the surface of the opposite side of the LNs that underwent FNA!
BH: a 42-year-old female was referred to us for FNA due to her thyroid nodule. The US showed a multinodular goiter. A microcalcified nodule 16 mm × 11 mm in size in the right thyroid lobe was considered important; a US-FNA was performed. Cytologic findings and diagnosis: Smears presented typical findings of thyroid papillary carcinoma []. Surgery and afterward: After a certain period, the patient angrily came to my office with the pathology report in her hand, trying to reproach me by saying; “It turned out to be benign after surgery. You told me it was cancer; you made me go through this stress.” I gave the preparations to the patient and directed her to the pathology institution that had reported that her nodule was benign.\nThe FNA slides received the diagnosis of “papillary carcinoma” during the consultation at the institution. Consequently, the thyroidectomy specimen was sampled again. It was determined that a nodule that was overlooked and not sampled the first time turned out to be “papillary carcinoma.”\nThe thyroidectomy material was sent to pathology from the operation theater with the note reading “multinodular goiter + total thyroidectomy.” The information of malignancy at FNA was not specified.\nTHM: (1) If the patient had accepted the pathology report and not taken into account the FNA result, she could have experienced eventual metastasis because she would not have received radioactive iodine therapy and would not have been monitored. (2) Following the first pathology report, the surgeon did not take into account the incompatibility between the cytological and histological diagnoses. When the patient investigated herself, her condition turned out to be “real.”