title: Fine needle aspiration of a metastatic germ cell tumor to supraclavicular lymph node.
abstract: OBJECTIVE
  Germ cell tumors are the most common tumors in men in their second decade. According to the National Comprehensive Cancer Network, the management of germ cell tumors depends on whether the tumor is diagnosed as a seminoma or a nonseminoma. Fine needle aspiration biopsy, compared to incisional biopsy, is relatively safe and facilitates rapid assessment of these tumors.
  
  
  METHODS
  An ultrasound guided FNA biopsy was performed, and air-dried slides and alcohol-fixed slides were made for Diff-Quik staining and Papanicolaou staining, respectively. The syringes were rinsed and cell block was prepared. The resected specimen was fixed in 10% formalin and processed by routine histology techniques.
  
  
  RESULTS
  We report a case of a 22-year-old male with an enlarged scrotal mass and a supraclavicular nodule. A superficial fine needle aspiration biopsy was performed on the nodule and the correct diagnosis was made via cytomorphology and immunohistochemistry. The cytologic diagnosis was correlated with the incisional biopsy results.
  
  
  CONCLUSIONS
  Fine needle aspiration biopsy is very helpful in the initial triage of germ cell tumors. When the aspirate contains sufficient diagnostic material, a specific diagnosis may be reached. Likewise, as different germ cell tumors have characteristic immunohistochemical profiles, a cell block from an aspirate may be critical for correct diagnosis. However, because germ cell tumors often contain mixed elements, cytologic diagnosis may not be entirely representative due to incomplete sampling. Thus, it is important to correlate cytologic diagnosis with the excisional tissue biopsy results.
authors.forename: Xiu
authors.initials: X
authors.lastname: Yang
authors.forename: Adam
authors.initials: A
authors.lastname: Cole
authors.forename: Antonio
authors.initials: A
authors.lastname: Cajigas
authors.forename: Samer
authors.initials: S
authors.lastname: Khader
mesh_terms: D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D002968:Clavicle; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D006651:Histocytochemistry; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D009919:Orchiectomy; D012611:Scrotum / Q000473:pathology* / Q000601:surgery; D016707:Tissue Fixation; D055815:Young Adult