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 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.