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What we see:

• The lymphoid population is predominated by small lymphocytes. There are mildly increased numbers of neutrophils. 
• Many neoplastic cells are present in clusters as well as individually. These cells are large and have rounded to polygonal borders, a large amount of basophilic cytoplasm which is sometimes vacuolated, and round nuclei.
• There is significant criteria of malignancy including moderate to marked anisocytosis and anisokaryosis, prominent nucleoli, and occasional multinucleation.

• Interpretation: Metastatic carcinoma
  
  

Let's talk about this case...

• There are many clusters of atypical epithelial cells in this aspirate, indicating metastatic carcinoma. 
• Advanced imaging was performed on the head, and a mass was observed in the left nasal cavity. It was not aspirated; however, it was safely presumed that the neoplastic epithelial cells found in the lymph node were metastatic from a nasal carcinoma.