Supraclavicular swelling: A cytomorphological study

Abstract

Swelling in the supraclavicular region gives rise to various doubts regarding the underlying pathology. As swellings in the supraclavicular fossa are easily palpable, FNAC is considered as the first line of investigation for diagnostic evaluation of swellings at this site. The study aimed at the analysis of distribution of different causes of supraclavicular swelling on the basis of cytomorphology and to study socio-demographic features of different cytomorphological patterns. This was a retrospective study to be conducted in the Department of Pathology covering a period of two and a half year (January 2019 to June 2021). Eighty-one (81) cases of supraclavicular swellings underwent FNAC during the study period were analyzed. For each case, a minimum of two air-dried Giemsa stained smears and one alcohol fixed Papanicolaou (PAP) stained smear were studied.Out of total 81 cases, 38 (46.9%) were non-neoplastic and 43 (53.1%) were neoplastic. Non-neoplastic cases were most commonly found in young age group and neoplastic cases were commonest in 41 – 60 year age group. Males (51 cases) were more commonly affected than females (30 cases). Most common non-neoplastic lesion is reactive lymph node (32% of all cases) followed by non-tubercular granuloma cases, tubercular granuloma, cystic lesion and hemangioma. Among the neoplastic conditions there were 34 cases of metastasis, (adenocarcinoma being the most common metastasis) and 9 cases of Non-Hodkin lymphoma. Non-neoplastic cases were common in tribal population (20 out of 38 cases) and 33 cases, out 43 of neoplastic lesions were found in non-tribal population. This study showed that neoplastic conditions affected the supraclavicular region/lymph node more commonly than the non-neoplastic lesions. The cytological evaluation of such cases will certainly guide the clinician to make an appropriate treatment plan.