Evaluation of Fine Needle Aspiration Cytology of Cervical Lymphadenopathies at Tertiary Care Center
Keywords:
Fine needle aspiration cytology, cervical lymph nodes, metastatic malignancies
Abstract
Background: Lymphadenopathies in the neck region is the most frequently sent for the cytology evaluation from the clinicians, involvement in regional and systemic diseases and their easy accessibility make the FNAC as a primary workup. Inflammatory and immune reactions are the most frequent causes of lymph node enlargement and are self limiting in majority of cases. Tuberculosis can also be diagnosed by cytology of affected lymph nodes. With the advent of FNAC, most of the inflammatory, reactive and neoplastic conditions can be diagnosed without biopsy. It has the advantage that it can be done safely, rapidly and cheaply with minimal trauma at an outpatient setup or at the bedside.Methods: This study was conducted at cytology section of pathology department of our institute. Patients from ENT, Surgery, Medicine, Pulmonary medicine departments were referred for FNAC. Written informed consent was obtained from all patients. It included patients with lymphadenopathies in cervical region. FNAC was conducted with the help of a 24 guage disposable needle attached to a 10cc syringe. Smears were fixed in methanol and stained with Haematoxylin and Eosin as well as Papanicolaou stains. MGG stain was done on air dried smears. The results expressed as percentage were tabulated.Result: Maximum numbers of patients were diagnosed with Reactive Lymphadenopathy 67/266 (25%), followed by Chronic Granulomatous Inflammation 59/266 (22 %), Metastatic 52/266(20%), Acute Suppurative 37/266 (14%), Tuberculous 27/266 (10%), Non Specific 14/266 (5 %), Lymphoma (primary) 8/266 (3%) and miscellaneous 2/266 (1%) consists Sinus Histiocytosis & Kawashaki disease. Histopathological correlation was available in 25/266 cases.Conclusion: FNAC is a safe, simple & inexpensive primary immediate diagnostic procedure and workup for lymph node enlargements, especially in cervical lymphadenopathies where biopsies are not done routinely. DOI: 10.21276/APALM.1527References
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10. Raghuveer CV, Leekha IL, Pai MR, Adhikari P. Fine needle aspiration cytology versus fine needle sampling without aspiration. A prospective study of 200 cases. Indian J Med Sci 2002;56:431–9.
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13. Troxell ML, Charles DB, Athena MC, Yasodha N. Cytologic diagnosis of Burkitt lymphoma: role of ancillary techniques. Cancer Cytopathol 2005;105:310–8.
14. Sun HB, Zheng XF, Zhang J. Diagnostic accuracy of fine needle aspiration biopsy of cervical lymph node: a study of 580 cases. Zhonghua Bing Li Xue Za Zhi 2008;37(10):693–7.
15. Narang R, Pradhan S, Singh R. Place of fine needle aspiration cytology in the diagnosis of lymphadenopathy. Ind J Tuberc 1990;37(1):29–31.
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20. Adhikari P, Sinha BK, Baskota DK. Comparison of fine needle aspiration cytology and histopathology in diagnosing cervical lymphadenopathies. AMJ 2011; 4: 97-99.
21. Sarwar A, Haque A, Aftab S, Mustafa M, Moatasim A, Siddique S et al. Spectrum of Morphological Changes in Tuberculous Lymphadenitis. International Journal of Pathology 2004; 2:85-89.
22. Alam K, Khan AH, Siddiqui FA, Jain A, Haider N. Fine Needle Aspiration Cytology (FNAC), a handy tool for metastatic lymphadenopathy. The Internet Journal of Pathology 2010;10. Available from:http://www.ispub.com/journal/the_internet_journal_of_pathology
23. Bhagwan IN, Kane SV, Chinoy RF. Cytologic Evaluation of the Enlarged Neck Node: FNAC Utility in Metastatic Neck Disease. The Internet Journal of Pathology 2007; 6:2. Available from: http://www.ispub.com/journal/the_internet_journal_of_pathology
24. Ghartimagar D, Ghosh A, Ranabhat S, Shrestha MK, Narasimhan R, Talwar OP. Utility of fine needle aspiration cytology in metastatic lymph nodes. Journal of Pathology of Nepal 2011; 1: 92-95.
25. Martin MR, Santos GC. Fine Needle Aspiration Cytology in the diagnosis of superficial lymphadenopathy: a 5 year Brazilian experience. Diagn Cytopathol 2006; 34:130-134
26. Hoftr S, Muhle C, Brenner W, Sprenger E, Maune S. Fine-Needle Aspiration Cytology of the Sentinel Lymph Node in Head and Neck Cancer. J Nucl Med 2002; 43:1585–9
27. Loya AC, Pragya AK, Arora A, Sundaram UC, Rao IS, Uppin SG et al. Lymph node metastasis of soft tissue tumours: A Cytomorphologic study. Acta Cytol 2007; 51: 153-160
2. Das DK. Value and limitation of fine-needle aspiration cytology in diagnosis and classification of lymphomas: a review. Diagn Cytopathol 1999;21:240–9
3. Howlett DC, Harper B, Quante M, Berresford A, Morley M,Grant J. Diagnostic adequacy and accuracy of fine needle aspiration cytology in neck lump assessment: results from a regional cancer network over a one year period. J Laryngol Otol 2007;121(6):571–9
4. Kollur SM, El Hag IB. Fine needle aspiration cytology of metastatic nasopharyngeal carcinoma in cervical lymph nodes: comparison with metastatic squamous cell carcinoma and Hodgkin’ and Non-Hodgkin’ lymphoma. Diagn Cytopathol 2003;28:18–22
5. Al-Mulhim AS, Hafez NH, Tahoun NS, Reliability of fine needle aspiration cytology (FNAC)as a diagnostic tool in cases of cervical lymphadenopathy, Journal of the Egyptian National Cancer Institute 2011; 23(3), 105–114
6. Mohanty R, Wilkinson A, Utility of Fine Needle Aspiration Cytology of Lymph nodes IOSR J of Dental and Med Sciences (IOSR-JDMS) 2013;8(1):13-18
7. Hirachand S, Lakhey M, Akhter J, Thapa B. Evaluation of fine needle aspiration cytology of lymph nodes in Kathmandu Medical College, Teaching hospital. Kathmandu Univ Med J 2009;7 (26):139–42
8. Keit Al-Ghamdi AM, Al-Marzooq HM, Mohammad HA, Gharib IA. The role of fine needle aspiration cyto and imprint cytology in cervical lymphadenopathy.Saudi Med J 2004;25:862-5.
9. Haque MA, Talukder SI. Evaluation of fine needle aspiration cytology of lymph node in Mymensingh. Mymensingh Med J 2003;12(1):33–5
10. Raghuveer CV, Leekha IL, Pai MR, Adhikari P. Fine needle aspiration cytology versus fine needle sampling without aspiration. A prospective study of 200 cases. Indian J Med Sci 2002;56:431–9.
11. Shakya G, Malla S, Shakya KN, Shrestha R. A study of fine needle aspiration cytology of cervical lymph nodes. J Nepal Health Res Counc 2009;7(14):1–5.
12. Jeffers MD, Milton J, Herriot R, McKean M. Fine needle aspiration cytology in the investigation on Non Hodgkin’ lymphoma. J Clin Pathol 1998;3:189–96.
13. Troxell ML, Charles DB, Athena MC, Yasodha N. Cytologic diagnosis of Burkitt lymphoma: role of ancillary techniques. Cancer Cytopathol 2005;105:310–8.
14. Sun HB, Zheng XF, Zhang J. Diagnostic accuracy of fine needle aspiration biopsy of cervical lymph node: a study of 580 cases. Zhonghua Bing Li Xue Za Zhi 2008;37(10):693–7.
15. Narang R, Pradhan S, Singh R. Place of fine needle aspiration cytology in the diagnosis of lymphadenopathy. Ind J Tuberc 1990;37(1):29–31.
16. Chieng DC, Cangiariella JF, Cohen JM. Fine needle aspiration cytology of Hodgkin disease: a study of 89 cases with emphasis on false negative cases. Cancer 2001;93(1):52–9.
17. Wakely PE. Fine needle aspiration cytopathology of malignant lymphoma. Clin Lab Med 1998; 18(3):541–7
18. Kochhar K, Patel B, Shah M. Pattern of Lymphadenopathy on Fine Needle Aspiration Cytology of Superficial Lymph Nodes (A Study of 150 Cases). JARBS 2012; 4: 288-292.
19. Khajuria R, Goswami KC, Singh K, Dubey VK. Pattern of Lymphadenopathy on Fine Needle Aspiration cytology in Jammu. JK Science Journal of Medical Education and Research 2006; 8:157-159.
20. Adhikari P, Sinha BK, Baskota DK. Comparison of fine needle aspiration cytology and histopathology in diagnosing cervical lymphadenopathies. AMJ 2011; 4: 97-99.
21. Sarwar A, Haque A, Aftab S, Mustafa M, Moatasim A, Siddique S et al. Spectrum of Morphological Changes in Tuberculous Lymphadenitis. International Journal of Pathology 2004; 2:85-89.
22. Alam K, Khan AH, Siddiqui FA, Jain A, Haider N. Fine Needle Aspiration Cytology (FNAC), a handy tool for metastatic lymphadenopathy. The Internet Journal of Pathology 2010;10. Available from:http://www.ispub.com/journal/the_internet_journal_of_pathology
23. Bhagwan IN, Kane SV, Chinoy RF. Cytologic Evaluation of the Enlarged Neck Node: FNAC Utility in Metastatic Neck Disease. The Internet Journal of Pathology 2007; 6:2. Available from: http://www.ispub.com/journal/the_internet_journal_of_pathology
24. Ghartimagar D, Ghosh A, Ranabhat S, Shrestha MK, Narasimhan R, Talwar OP. Utility of fine needle aspiration cytology in metastatic lymph nodes. Journal of Pathology of Nepal 2011; 1: 92-95.
25. Martin MR, Santos GC. Fine Needle Aspiration Cytology in the diagnosis of superficial lymphadenopathy: a 5 year Brazilian experience. Diagn Cytopathol 2006; 34:130-134
26. Hoftr S, Muhle C, Brenner W, Sprenger E, Maune S. Fine-Needle Aspiration Cytology of the Sentinel Lymph Node in Head and Neck Cancer. J Nucl Med 2002; 43:1585–9
27. Loya AC, Pragya AK, Arora A, Sundaram UC, Rao IS, Uppin SG et al. Lymph node metastasis of soft tissue tumours: A Cytomorphologic study. Acta Cytol 2007; 51: 153-160
Published
2018-01-27
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