APPLICATION OF THE NOVEL SYDNEY SYSTEM IN CLASSIFICATION AND REPORTING OF LYMPH NODE FINE NEEDLE ASPIRATION CYTOLOGY

Abstract

Background: Fine Needle Aspiration Cytology (FNAC) is a useful, inexpensive and reliable tool in assessing the lymph node pathology. However, there is no uniform reporting system for lymph node cytology which hampers its vast acceptance among clinicians and cytopathologists. In May 2019, the 20th International Congress of Cytology held in Sydney proposed a categorical system for performance, classication and reporting of lymph node cytopathology, known as the Sydney System. It has been endorsed by the International Academy of Cytology and the European Federation of Cytology Societies. Current study aims at evaluating the applicability of the proposed system. The study was Methods: done at Department of Pathology, Gandhi Medical College, Bhopal from 1 January 2021 to June 2021. Overall, 100 FNACs were reviewed and categorized as per the Sydney system. The diagnostic accuracy and risk of malignancy was assessed in each category. 100 FNACs were Results: reviewed and categorized as following- L1 (Inadequate/Non diagnostic) n=02 (02%), L2 (Benign) n= 68(68%), L3 (Atypical cells of undetermined signicance) n=02 (02%) L4(Suspicious for malignancy) n= 02 (02%), L5(Malignant) n=25(25%). FNACs were correlated with ancillary tests, histopathological diagnosis and clinical follow-up wherever necessary, to assess the diagnostic accuracy. Statistical analysis showed following results: sensitivity 86.2%, specicity 100%, positive predictive value 100%, negative predictive value 94.4%, accuracy 95.8%. Conclusion: FNAC coupled with various ancillary techniques ensures high diagnostic accuracy in diagnosing various lymph node pathology and the implementation of Sydney system may improve the practice among pathologists.