TY - JOUR
T1 - Supraclavicular lymph nodes
T2 - An easily accessible site for diagnosis and molecular profiling of malignancies in the era of precision medicine
AU - Bailey, Gabrielle E.
AU - Maleki, Zahra
N1 - Publisher Copyright:
© 2023 Wiley Periodicals LLC.
PY - 2023/11
Y1 - 2023/11
N2 - Background: The supraclavicular lymph node (SCN) is a common metastatic site for malignancies of supra and infra-diaphragmatic origin and is easily accessible for small biopsy and fine needle aspiration (FNA). In this study, the utility of SCN biopsies was analyzed for diagnosis and ancillary studies. Methods: The electronic pathology archive was searched for cases of FNA of SCNs accompanied by small core biopsies (1/2016–12/2018). The patients' demographics, diagnosis, and ancillary studies were recorded. Results: Eighty-eight cases were reviewed (49 females and 39 males), with patients' ages ranging from 23 to 84 years (mean = 52.85 years). Fifty-four (61.4%) specimens were from the left SCN and thirty-four (38.6%) from the right. All FNA cases were performed by a radiologist under ultrasound guidance and rapid on-site evaltion (ROSE) was performed by a cytologist. Nineteen cases (21.6%) were benign and sixty-nine cases were malignant (78.4%). Carcinoma was the most common malignant neoplasm (52.3%) including 38.2% (13/34) of the right SCN and 61.1% (33/54) of the left SCN cases. Metastatic lung and breast adenocarcinomas (9.1% each) were the most common carcinomas overall. Lymphoma was the second most common malignancy (17.0%) including 17.6% (6/34) of the right SCN and 16.7% (9/54) of the left SCN cases. The majority of cases were accomponied by ancillary studies for diagnosis and prognostic markers. Ancillary studies included immunostains (63 cases, 71.6%), PD-L1 testing (21 cases, 23.9%), FISH testing (7 cases, 8.0%), flow cytometry (20 cases, 22.7%) and NGS studies (8 cases, 9.1%). Conclusion: Supraclavicular lymph nodes are easily accessible and diagnostically useful sites for detection of malignancies and molecular alterations responsive to targeted or immune therapy.
AB - Background: The supraclavicular lymph node (SCN) is a common metastatic site for malignancies of supra and infra-diaphragmatic origin and is easily accessible for small biopsy and fine needle aspiration (FNA). In this study, the utility of SCN biopsies was analyzed for diagnosis and ancillary studies. Methods: The electronic pathology archive was searched for cases of FNA of SCNs accompanied by small core biopsies (1/2016–12/2018). The patients' demographics, diagnosis, and ancillary studies were recorded. Results: Eighty-eight cases were reviewed (49 females and 39 males), with patients' ages ranging from 23 to 84 years (mean = 52.85 years). Fifty-four (61.4%) specimens were from the left SCN and thirty-four (38.6%) from the right. All FNA cases were performed by a radiologist under ultrasound guidance and rapid on-site evaltion (ROSE) was performed by a cytologist. Nineteen cases (21.6%) were benign and sixty-nine cases were malignant (78.4%). Carcinoma was the most common malignant neoplasm (52.3%) including 38.2% (13/34) of the right SCN and 61.1% (33/54) of the left SCN cases. Metastatic lung and breast adenocarcinomas (9.1% each) were the most common carcinomas overall. Lymphoma was the second most common malignancy (17.0%) including 17.6% (6/34) of the right SCN and 16.7% (9/54) of the left SCN cases. The majority of cases were accomponied by ancillary studies for diagnosis and prognostic markers. Ancillary studies included immunostains (63 cases, 71.6%), PD-L1 testing (21 cases, 23.9%), FISH testing (7 cases, 8.0%), flow cytometry (20 cases, 22.7%) and NGS studies (8 cases, 9.1%). Conclusion: Supraclavicular lymph nodes are easily accessible and diagnostically useful sites for detection of malignancies and molecular alterations responsive to targeted or immune therapy.
KW - cell block
KW - fine needle aspiration biopsy
KW - immunostaining
KW - metastatic carcinoma
KW - molecular
KW - small core biopsy
KW - supraclavicular lymph node
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U2 - 10.1002/dc.25202
DO - 10.1002/dc.25202
M3 - Article
C2 - 37528573
AN - SCOPUS:85166668744
SN - 8755-1039
VL - 51
SP - 689
EP - 697
JO - Diagnostic cytopathology
JF - Diagnostic cytopathology
IS - 11
ER -