Comparison of Usefulness of Ultrasound-Guided Fine Needle Aspiration and Core Needle Biopsy in Diagnosis of Cervical Lymphadenopathy

Abstract

Background and Objectives The purpose of this study is to compare diagnostic outcome and safety of fine needle aspiration (FNA) and core needle biopsy (CNB) in patients with cervical lymphadenopathy. Subjects and Method This retrospective studies were conducted on 164 cases with cervical lymphadenopathy that had undergone FNA, and 44 cases that had undergone CNB. The cytopathological results from FNA and CNB were compared with the histopathological results confirmed by excisional biopsy in the nodes according to different sizes and radiological levels, respectively. Diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were evaluated according to disease entities.Results FNA is more accurate than CNB in most of the sizes and at all cervical levels. However, there is no statistically significant difference between the results of the two tests. Sensitivity and NPV for diagnosis of malignant lymphoma are higher with FNA than with CNB. However, specificity and PPV for malignant lymphoma are higher with CNB than with FNA. Also CNB showed superior sensitivity, PPV and NPV for metastatic lymphadenopathy. Conclusion Although CNB is beneficial in reducing the false negative rate, it still has several limitations. Since CNB has no statistically significant advantage over FNA, FNA can be a good alternative method with less complication and high diagnostic value for lesions where CNB is difficult to perform.