Clinical data: A 42-year-old man was referred for aspiration cytology of a lymph node which was detected 5 months ago. FNA in another hospital resulted in benign, heterogeneous pattern. At that time, the node was measured as 23x13 mm. The patient felt that the node has gradually increased since the first noticing.

Palpation: A very firm node in the left supraclavicular region.

Laboratory tests: TSH 1.18 mIU/L.

Ultrasonography. The thyroid was echonormal and intact. There was a large and several small lymph nodes in the left supraclavicularegion. The nodes did not have hilum, the largest one presented with irregular margins and irregular vascularity. The diameters of the node were 31x23x45 mm, width, depth, length, respectively.

Cytology resulted in suspicion of non-Hodgkin lymphoma based on the exclusive presence of atypical lymphoblasts.

Biopsy was performed. Histopathology disclosed diffuse large B-cell lymphoma.