椒盐样的细胞核，转移的小细胞癌不除外。建议查肺。

 淋巴组织反应性增生？

 细胞比较散，没有相互嵌套，不太像小细胞癌。

首先考虑大细胞淋巴瘤。

 同意，考虑淋巴瘤。

 还是做活检后再说吧,真说不清!

 倾向转移小细胞癌

 倾向转移小细胞癌

 倾向转移小细胞癌，但也不能排除淋巴瘤，免疫组化结果怎样？

 不能排除转移小细胞癌。

 倾向转移小细胞癌

 淋巴瘤。有瑞士染色的话传两张

 Very intresting case and again, we have 2 different diagnoses (small cell carcinoma vs. lymphoma) which can result in 2 completely different treatments. Small cell carcinoma is almost a death sentence and lymoma though can be treated and patient can survive much longer.  This differential diagnosis can be very difficult. Although I did not see lympho-glandular bodies in this case, which may point to lymphoma, but that is not 100% specific. I put my lymph node FNA sample in RPMI medium and if the smear show the above differential diagnosis, I sent the sample for flow cytometry and add the marker of CD56, if the flow did not show monoclonality and CD56 is strongly positive, then it is small cell carcinoma, if it is the other way around, then lymphoma. It is very useful.

 倾向于NHL。

 淋巴瘤

 

倾向转移小细胞癌

 部位像是鼻咽癌转移好发部位，细胞也有癌的特征，常规应该去查一下鼻咽部吧，期待楼主跟帖发布最后答案