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To the Editor.—Small, soft, elliptical lymph nodes frequently palpable in the superficial areas of the cervical region are most often benign in nature, and are related to an accompanying infection of the head or neck. In contrast, metastases from malignancies at these sites metastasize predominantly to the deep cervical glands. Carcinoma of the thyroid gland is found predominantly in the upper or lower deep cervical nodes.
Diagnostic surprises will occur, however, as the apparence of a lymph node, measuring about 1.0 × 0.5 cm, in the right side of the neck just above the clavicle and under the platysma muscle attested. The lesion was considered benign but, because it was the same at the end of 2 weeks, an excision biopsy was performed. A most unexpected diagnosis of papillary adenocarcinoma of the thyroid gland was made. All preoperative diagnostic test results were within normal limits.
At the time of
MILLER JM. Elliptical Lymph Nodes. Arch Otolaryngol Head Neck Surg. 1989;115(8):994–995. doi:10.1001/archotol.1989.01860320104032
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