BH: A 65-year-old male presented with a 40 mm × 25 mm LN extending to the supraclavicular region in the right cervical chain in the neck. The right lung had a 3 cm area with a “ground-glass” appearance. Moreover, a cystic nodule 25 mm × 15 mm in size was present in the right thyroid. Clinical preliminary diagnosis was malignant; the primary focus was investigated (thyroid/lung?). US-FNA was applied to the LN and right thyroid nodule. The FNA of the thyroid nodule displayed findings compatible with “cystic degenerated adenomatous nodule.” LN cytologic findings: individually, scattered and sporadic groups of malignant cells were observed. The large cytoplasm cells had vacuoles and large, dark nuclei with sporadic pleomorphism []. Cytologic diagnosis: Adenocarcinoma. The diagnosis was interpreted as consistent with the metastasis of lung adenocarcinoma supported by the clinical/imaging picture. Follow-up: Diagnosis was confirmed by the histoimmunopathologic examination of the LN core biopsy.
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.[]