Abstract
We present a case with an initial presentation of smooth nasopharyngeal mucosa and vague left upper neck swelling. Palpation-guided fine-needle aspiration was performed initially, but the specimen was inadequate and showed only blood. Ultrasound-guided fine-needle aspiration of the lymph node was conducted, and cytology suggested metastatic carcinoma. In addition, computed tomography with detailed endoscopic examination and biopsy of the nasopharynx finally confirmed nasopharyngeal carcinoma. Serial change of the malignant lymph node after irradiation was followed by ultra-sound and disappeared on the third month after radiotherapy. Our experiences with this case highlight the benefits of ultrasound-guided fine-needle aspiration for clinically vague neck masses, in avoiding unnecessary and harmful open biopsies in the diagnosis of nasopharyngeal carcinoma patients.
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