Massive mystery mass: Cytological diagnosis of a neck swelling

40-year-old male presented with gradually progressive neck swelling in right cervical region for the last six years [Figure 1a]. On examination, the swelling was firm to hard, fixed and non-tender. There was no hoarseness of voice, difficulty in breathing, swallowing, history of fever, weight loss or any surgical intervention. Fine needle aspiration cytology (FNAC) was performed as a frontline investigation and the patient was advised radiological investigations [Figure 1b]. FNAC revealed scant, sticky material and smears were stained using May Grunwald Giemsa (MGG stain).