Skeletal structures that clinically simulate lymph nodes: encounters during fine-needle aspiration.
We report eight patients in whom bones of the cervical spine or cervical ribs were clinically mistaken for jugular chain or supraclavicular lymphadenopathy, respectively. Each was referred for fine-needle aspiration by an experienced surgeon, oncologist, rheumatologist, or otolaryngologist. In the neck, the bony nature of the pseudo-lymph nodes was apparent when the needle contacted bone. Bone was not contacted by the needle in the supraclavicular fossa. Aspiration smears showed normal soft tissues in all cases. Radiographs showed cervical ribs in both of the patients with supraclavicular pseudo-lymphadenopathy. One of these was surgically explored and no adenopathy was detected. Radiographically, one patient with jugular chain findings had unilateral enlargement of a transverse vertebral bone process, another showed scoliosis, and a third had a normal cervical spine study. During follow-up of 1-33 mo (median = 14 mo), no patient developed adenopathy at any additional site. All are alive and well.
Stanley
M W
MW
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock 72205.
Knoedler
J P
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D003951:Diagnostic Errors; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008206:Lymphatic Diseases / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012272:Ribs / Q000473:pathology*; D013131:Spine / Q000473:pathology*