Supraclavicular lymph nodes: An easily accessible site for diagnosis and molecular profiling of malignancies in the era of precision medicine.

cell block fine needle aspiration biopsy immunostaining metastatic carcinoma molecular small core biopsy supraclavicular lymph node

Journal

Diagnostic cytopathology
ISSN: 1097-0339
Titre abrégé: Diagn Cytopathol
Pays: United States
ID NLM: 8506895

Informations de publication

Date de publication:
Nov 2023
Historique:
revised: 18 07 2023
received: 17 03 2023
accepted: 19 07 2023
medline: 3 10 2023
pubmed: 2 8 2023
entrez: 2 8 2023
Statut: ppublish

Résumé

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. 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. 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%). Supraclavicular lymph nodes are easily accessible and diagnostically useful sites for detection of malignancies and molecular alterations responsive to targeted or immune therapy.

Sections du résumé

BACKGROUND 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 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 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 CONCLUSIONS
Supraclavicular lymph nodes are easily accessible and diagnostically useful sites for detection of malignancies and molecular alterations responsive to targeted or immune therapy.

Identifiants

pubmed: 37528573
doi: 10.1002/dc.25202
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

689-697

Informations de copyright

© 2023 Wiley Periodicals LLC.

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Auteurs

Gabrielle E Bailey (GE)

Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Zahra Maleki (Z)

Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

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