9/9/2023 0 Comments Swollen occipital lymph nodes![]() a Hematoxylin and eosin (H and E) stained section shows diffused tumor cells displaying characteristics of nasopharyngeal carcinoma (NPC) cells. Representative images of pathologic slices from fine-needle aspiration of the occipital lymph node (original magnification, ×40). Immunohistochemical analysis and in situ hybridization of the occipital lymph node further confirmed the presence of EBV-encoded RNAs (EBERs), indicating EBERs expression in tumor cells (Fig. The pathologic report after hematoxylin and eosin (H and E) staining identified poorly differentiated carcinoma, which suggested metastasis from NPC (Fig. Because of the possibility, though rare, of NPC-caused metastasis in the occipital region, a fine-needle aspiration of the occipital lymph node was also performed. EBV levels were abnormally elevated: EBV viral capsid antigen (VCA)-IgA, 1:640 EBV early antigen (EA)-IgA, 1:40 and EBV-DNA, 8.82 × 10 5 copies/mL.īiopsy of the nasopharyngeal neoplasm confirmed undifferentiated non-keratinizing carcinoma. The laboratory results were normal except for the results of Epstein-Barr virus (EBV). In addition, an occipital lymph node of 2 cm × 2 cm was palpable, with medium firmness and clear edge. Physical examination showed a neoplasm in the nasopharynx and several enlarged cervical lymph nodes of bilateral levels II–V the largest one was 10 cm × 8 cm. He had no history of trauma, surgery, smoking, or drinking. The patient did not complain any of the following symptoms: fever, nose bleeding, obstruction, tinnitus, diplopia, or headache. Trachea, esophagus, and prevertebral fasciaĪ 19-year-old man from Jiangxi Province, China, was admitted with the chief complaint of bilateral cervical masses for 3 months. Posterior border of the sternocleidomastoid muscle Horizontal plane defined by the lower border of the cricoids cartilage Posterior border of the sternocleidomastoid muscle or sensory branches of cervical plexus Horizontal plane defined by the lower border of the cricoid cartilage Lateral border of the sternocleidomastoid or sensory branches of cervical plexusĪpex of the convergence of the sternocleidomastoid and trapezius muscles Horizontal plane defined by the inferior border of the cricoid cartilage Horizontal plane defined by the inferior body of hyoid Lateral border of the sternocleidomastoid muscle Horizontal plane defined by the inferior body of the hyoid bone ![]() Vertical plane defined by the spinal accessory nerve Horizontal plane defined by the inferior border of the hyoid bone Anterior belly of contralateral digastric muscleĪnterior belly of ipsilateral digastric muscle
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