Fig. 1

There was one false-positive case in our study. Preoperative ultrasound found lymph nodes with heterogeneous echo texture overriding the common carotid artery (A). On cytology, the smear showed a tumor necrotic debris background with some keratinocyte-like cells (in orange color) and some cell shadows with enlarged nuclei (in green color). This finding was comparable to malignancy in cytology according to the Sydney system (B). In the final pathology with H&E staining, calcifications, histiocytes, and necrotic debris with necrotic keratinocyte-like cells were observed (C: low power & D: high power). Because there were no viable carcinoma cells, the final diagnosis was no metastatic carcinoma.