APPLICATION OF THE PROPOSED SYDNEY SYSTEM IN REPORTING OF THE LYMPH NODE CYTO-PATHOLOGY – A RETROSPECTIVE STUDY

Abstract

Introduction: Fine needle aspiration cytology (FNAC) is a widely accepted first line of investigation to diagnose the cause of lymphadenopathy. A standardized categorization and reporting system for lymph node cytology was proposed in 20th International Congress of Cytology at Sydney which consisted of 5 categories (L1, L2, L3, L4, L5) with management recommendations for each. Aims and Objective: To review the application of the Sydney system in achieving a uniform standardized approach for classifying and reporting lymph node cytology and to assess the risk of malignancy (ROM) for each category. : A 2 year single institute retrospective study. Clinical details were collected Materials and Methods from the patient records and cytology smears were reviewed by 2 cyto-pathologists as per the Sydney system. Histological correlation was done wherever possible. Statistical analysis was performed. 437 cases Results: were reevaluated, with mean age of 39.66 years, slight male preponderance and cervical lymph node being the most common site. L2/Benign was the most common category with reactive lymphoid hyperplasia being the most common diagnosis and metastatic squamous cell carcinoma was the most common L5/malignant diagnosis. Histopathological correlatio was available for 40 (9.1%) cases and the highest calculated risk of malignancy (ROM) was for L4 and L5 categories (100% each). The diagnostic accuracy of the proposed Sydney system in our study was 96.66%. The Conclusion: proposed Sydney system improves the diagnostic accuracy and standardizes the reporting of lymph node cytopathology. It improves the patient care by giving management recommendation to the clinicians.