Fig. 4

An 42-year-old female patient presented with breast cancer, the freehand technique was used and under ultrasound guidance, FNAC & core biopsy were obtained simultaneously, and the final histopathological evaluation showed metastatic lymph nodes harboring malignancy. a Axillary gray-scale ultrasonographic image demonstrates a suspicious lymph node, measuring 30 × 16 mm. It is oval in shape with effaced hilum. b Doppler US image shows that the lymph node has both hilar vascular flow as well as prominent cortical non-hilar blood flow at the periphery. c Needle pass during FNAC in the cortical region of the lymph node. d Needle pass during Tru-cut biopsy of the lymph node from cortical regions. e Photomicrograph of a lymph node cytology smear: multiple clusters of malignant epithelial cells on the lymphoid background (Papanicolaou stain, 400X). f Photomicrograph of tissue section of metastatic ductal carcinoma in the lymph node. Many nests and cords of neoplastic cells are separated by desmoplastic stroma (Hematoxylin and Eosin stain, 200X)