BH: A 20-year-old male had a mobile soft mass with a diameter of 30 mm that had been present for 6–7 months in the right supraclavicular region. Numerous LNs with diameters of 25, 25, and 15 mm were also detected in the right cervical region during the US. A US-FNA was performed. Cytologic findings: a heteromorphic structure composed of small-large lymphocytes and few eosinophils was observed. Sporadic and scattered epithelioid histiocytes and epithelioid histiocytic groups forming granuloma-like structures were noted on a reactive lymphoid background. “Atypical mononuclear cells with an undefined nature” were observed in the regions adjacent to these groups. Necrosis and typical granulomas were not observed []. Cytologic diagnosis and remarks lymphoid proliferation comprising a granulomatous reaction, which may be a component of granulomatous lymphadenitis (e.g., tuberculosis/sarcoid) or the reflection of an underlying neoplasia/lymphoproliferative lesion (Hodgkin's lymphoma) not represented by FNA. Histopathology: Mixed type Hodgkin's lymphoma.
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).