– Reactive lymphoid hyperplasia (see comment)

COMMENT: The aspirate smears and cell block show a heterogenous mixture of small and large lymphocytes with a predominance of small lymphocytes. Rare tingible body macrophages are seen. There is no evidence of granulomatous inflammation or epithelial malignancy. In addition, no Reed-Sternberg cells are identified. The findings support reactive lymphoid hyperplasia. If there is persistence or progression of the adenopathy, repeat biopsy may be considered, if clinically indicated.

 

  – Metastatic squamous cell carcinoma (see comment)

COMMENT: The aspirate smears are abundantly cellular and show clusters of malignant cells with enlarged, hyperchromatic nuclei and scant amounts of cytoplasm in a background of lymphocytes. Scattered malignant keratinizing cells are also identified. The findings are diagnostic of metastatic squamous cell carcinoma and the presence of lymphoid tissue suggests lymph node sampling.  Clinical and radiographic correlation is recommended.

 

  – Metastatic P16-positive squamous cell carcinoma (see comment)

COMMENT: The aspirate smears and cell block sections contain crowded, cohesive clusters of malignant epithelium characterized by high nucleus-to-cytoplasm ratios, nuclear contour irregularities, coarse chromatin, mostly inconspicuous nucleoli, and scant cytoplasm. The findings are diagnostic of metastatic non-keratinizing squamous cell carcinoma. An immunohistochemical stain for p16 shows strong, diffuse staining, consistent with an HPV-mediated process. Clinical and radiographic correlation is recommended.

 

  – Metastatic squamous cell carcinoma (see comment)

  – Equivocal for P16 by immunohistochemistry

COMMENT: The aspirate smears contain crowded, cohesive clusters of malignant epithelium characterized by high nucleus-to-cytoplasm ratios, nuclear contour irregularities, coarse chromatin, mostly inconspicuous nucleoli, and scant cytoplasm. The findings are diagnostic of metastatic non-keratinizing squamous cell carcinoma. The cell block contains only very rare fragments of tumor cells. Although an immunohistochemical stain for P16 does show some staining of the cells, given the very limited quantity of tissue and somewhat patchy staining, these findings are best interpreted as equivocal. Clinical and radiographic correlation is recommended.

 

  – Cytologically bland squamous lesion with cystic features (see comment)

COMMENT: The aspirate smears and ThinPrep slide are abundantly cellular and show numerous cytologically bland squamous cells and anucleate squamous cells in a background of histiocytes, scattered lymphocytes, and neutrophils. There is no evidence of epithelial malignancy. In the correct clinical setting, the findings are consistent with a branchial cleft cyst; however, clinical correlation is suggested to exclude the possibility of well-differentiated squamous cell carcinoma.

 

Last updated:  Sep 2, 2019