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: 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.