Brief history (BH): a 43-year-old female presented with a palpable mass in the right neck. US revealed a 20 mm × 15 mm hypoechogenic lymph node (LN) in the right cervical jugular region. During US-FNA, 3 cc of hemorrhagic cystic fluid was obtained. It was believed that the cystic LN could be associated with papillary thyroid carcinoma. US was performed on the thyroid, which had not previously undergone US. The radiologist detected an 8 mm × 6 mm microcalcified nodule in the right lobe. FNA was also performed on this nodule.\nCytologic findings: (i) LN: smears from cystic fluid showed clusters of atypical thyroid follicular cells on a cystic background with hemosiderin-laden macrophages. (ii) Thyroid nodule: the hypercellular samples revealed atypical papillary clusters with occasional intranuclear vacuoles and grooves []. Cytologic diagnosis: LN: Metastasis of cystic papillary thyroid carcinoma. Right thyroid nodule: Thyroid papillary carcinoma. The cytologic diagnosis was confirmed histopathologically.\nTHMs: After the fluid was obtained from the LN during the FNA, “metastasis of thyroid papillary carcinoma,” which comes to mind first in the differential diagnosis of lesions that form cystic degenerations at the LN, was considered.[] Other lesions included in the differential diagnosis were hemangioma, metastasis from malignity in the salivary gland, squamous cell carcinoma, and malignant melanoma.[]
BH: US-FNA was requested for a 45-year-old male due to the presence of a palpable LN 2.5 cm below the sternocleidomastoid muscle in the right neck and 1 cm below the sternocleidomastoid muscle in the left neck. US-FNA was performed on these two lesions.\nCytologic findings: Epithelioid histiocytes and epithelioid histiocytic clusters forming granuloma-like structures were observed on a reactive lymphoid background. Undifferentiated malignant cells, which formed scattered groups around granulomatous structures, were also noted. Cytologic diagnosis: an undifferentiated malignant tumor that could be a metastasis of nasopharyngeal carcinoma/Hodgkin's lymphoma []. Histopathology: Nasopharyngeal carcinoma (nonkeratinized squamous cell type).