Cytological diagnosis of bilateral supraclavicular swellings – Be aware of the rare

Abstract

Cervical lymphadenopathy is the most common clinical presentation in many infective and neoplastic lesions. Most common lesions among them are reactive lymphoid hyperplasia, tuberculosis, and metastatic deposits. Fine-needle aspiration cytology is a reliable diagnostic tool for patients with cervical lymphadenopathy to know the various lesions and helps in deciding further management. The American Joint Committee on Cancer classifies cervical lymph nodes into level 1 to 7, of which supraclavicular lymph nodes comprise level 5. The major cause for enlargement of supraclavicular lymph nodes is metastatic malignancy deposits followed by either Hodgkin's disease or non-Hodgkin's lymphoma. We present an interesting case of a male patient clinically manifested with initial asymptomatic bilateral supraclavicular swellings and finally diagnosed with metastatic deposits of germ cell tumor, seminoma, from testis on cytological study in constellation with clinical and radiological findings.