Cytomorphological profile of lymph nodes at a tertiary care centre in Uttar Pradesh: A retrospective study

Abstract

Fine Needle Aspiration Cytology (FNAC) is a quick, reliable, minimally invasive and cost effective diagnostic modality for evaluation of superficial lymph nodes and has been accepted as a first line investigation in most centres. The aim of the study was to identify the patterns of pathologies in aspiration cytology of lymph nodes in a tertiary care hospital located in Uttar Pradesh, India. The study was undertaken as a retrospective study using data in the Department of Pathology, G.S Medical College and Hospital, Uttar Pradesh, India. 235 lymph node FNACs that were performed during the two year span of 2018-19 were analysed. Females comprised 59.6% of the total patients who underwent lymph node FNAC procedure, 95 (40.4%) were males. The youngest patient was a 3 month old and the oldest happened to be 78 years. Lymph node enlargement was traced to malignant processes exclusively above 40 years of age. Uptill that age, tuberculosis seems to be the major cause underlying lymphadenopathy, mostly presenting as granulomatous lymphadenitis. Out of all cases which showed granulomatous or necrotic features, 27% showed the presence of AFB, hence confirming tuberculosis. A vast majority of the FNACs were performed for cervical lymphadenopathy (92.8%). 42.1% of the FNACs revealed reactive morphology. This diagnosis was closely followed by granulomatous lymphadenitis in 29.4% patients. Together with a definite diagnosis of tuberculous lymphadenitis, patients with granulomatous lymphadenitis comprised 42.6% of all diagnoses. 12 patients received a diagnosis of suppurative lymphadenitis, 9 received necrotizing lymphadenitis. 12 patients were diagnosed as metastatic carcinoma and 1 was suggestive of lymphoma. Most of the lymph nodes whose sizes were under 1 cm were reactive on cytology. Lymphadenopathy due to malignant etiology presented with lymph nodes measuring at least 2 cm. Granulomatous/tuberculous lymphadenitis presented in lymph nodes of varying sizes, from as small as 0.5 cm to larger ones.