(A) Cross-sectional (axial) sonographic image showing a 21-gauge fine-needle aspiration cytology needle introduced in a 12 mm supraclavicular lymph node.

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(A) Cross-sectional (axial) sonographic image showing a 21-gauge fine-needle aspiration cytology needle introduced in a 12 mm supraclavicular lymph node (white arrow). (A) Cross-sectional (axial) sonographic image showing a 21-gauge fine-needle aspiration cytology needle introduced in a 12 mm supraclavicular lymph node (white arrow). (B) Adapted version of the updated 2011 diagnostic pathway published by the National Collaboration Centre for Cancer (NICE Clinical Guidelines, CG121 April 2011) emphasising on the sole role of neck nodes in reaching a diagnosis decision leading to treatment (curative or palliation). All rights reserved.5 Amir Awwad et al. BMJ Open Resp Res 2015;2:e000075 ©2015 by British Thoracic Society