Concluded Case

Neck swelling with ulcerated area 24/Male

Superficial ulcerated neck swelling midline region meas 0.9x0.6 cms,fixed, Tender, discharging pus from ulcerated area, swelling present from last 3 months, patient already completed antibiotic course but did not subside. Touch Smears prepared from the ulcerated area. Probable diagnosis?

(Edited)

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Concluded answer

Scattered squamous cells.. some reveal atypia... amidst dense mixed inflammatory exudate... dominated by neutrophils. Also amorphous debris. Few cyst macrophages. Infected keratinous cyst.. Dd. Infected branchial cyst. Sug. Bx

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Scattered squamous cells.. some reveal atypia... amidst dense mixed inflammatory exudate... dominated by neutrophils. Also amorphous debris. Few cyst macrophages. Infected keratinous cyst.. Dd. Infected branchial cyst. Sug. Bx

Thank you for the prompt response Sir. Actually this patient was referred from ENT Deptt and they were suspecting Tubercular etiology, and specifically asked for AFB stain. But AFB came out to be negative. And there are lots of squamous cells and mixed inflammatory infiltrate only in a dirty background.
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Few cyst Macrophage with scattered squamous cells Acute on chronic inflamation ? Infected bronchial cyst

acute on chronic inflammatory lesion

acute inflammatory lesion

Dr Makhija, what are those big cells in between with Round nucleus and bluish cytoplasm? And those binucleate cells? Can be seen in few pics
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