Liao, "Occultpapillary thyroid carcinoma initially presenting as cervical cystic lymph node
metastasis: Report of two cases," Journal of Medical Ultrasound, vol.
Other neck lesions that present as cystic swellings include cystic lymph node
metastases from head and neck squamous cell carcinomas (SCCs) and papillary thyroid carcinomas [3, 4].
Since it could not be determined whether the cystic lymph node
was caused by cancer metastasis, malignant lymphoma, or inflammatory disease, the patient underwent right radical nephrectomy with retroperitoneal localized lymphoidectomy in consideration for his general status.
This cystic lymph node
metastasis may therefore have been misinterpreted as a benign cervical cystic mass.
Tuberculous enlargement of the cystic lymph node
can cause the gallbladder to become distended and palpable and present with cholecystitis.
In the cases of papillary thyroid carcinoma, a cystic lymph node
detection by ultrasonography suggests the presence of locally metastatic disease [21,23] In this study, seven lymph nodes showed necrosis on ultrasound of which only two were positive for malignancy.
Mutational analysis was also performed in the cystic lymph node
(4) Among these, cystic lymph node
metastasis deserves particular mention; in our patient, the palpated cystic mass in the left side of the neck was initially thought to be a metastatic cystic lymph node
from a papillary carcinoma of the thyroid gland.
Two of the largest of such studies failed to identify a single case meeting these criteria among 440 patients, (10-11) most eventually proving to be cystic lymph node
metastases from a primary squamous cell carcinoma in the head and neck region.
(5) Some authors, however, have postulated that cases described as papillary carcinomas arising in thyroglossal duct cysts actually represent cystic lymph node
metastases from primary papillary carcinomas of the thyroid gland.
Sometimes thyroglobulin can be identified in FNAB irrigation fluids for cystic lymph nodes
, in which case a thyroglobulin level of more than 100 ng/mL in the
As an accurate method to detect CLN metastases, FNA-Tg is better than FNAC for accuracy in detecting cystic lymph nodes
.18 In our work, there were eight false-negative cases by FNA-Tg/serum Tg, which were caused by puncture deviation and suction of the adipose tissue.