BH: In a 35-year-old female, a hypoechoic lesion 35 mm × 15 mm in size with a cystic appearance was detected during the US due to the presence of a palpable mass in the left neck. During the US, it was noted that the cyst had no septa inside, its wall was thin, and the lesion of the cyst was almost completely full. Cytologic findings: squamous epithelial cells were observed between sporadic inflamed cells on a dirty cystic background. It was noted that some squamous cells had dyskaryotic structures with pyknotic nuclei while reactive atypia was observed in a few cells []. Cytologic diagnosis: Branchial cyst.\nTHM: the cytopathologist noted that the lesion was cystic, and 10 cc of clear yellow fluid was obtained from the aspiration, during which the lesion shrank, which suggested that it could be a thin-wall cystic lesion. Cytodifferential diagnosis: Salivary gland lesion (e.g., Warthin tumor), cystic hygroma, cystic thyroid lesions, purulent inflammation (apsis) and metastasis of cystic squamous cell carcinoma (larynx, head/neck associated). In addition, squamous cell carcinoma cases associated with branchial cysts were defined in the literature.[]
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).