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.1527
Highlights
Cervical lymphadenopathy is commonest clinical presentations of patients, attending the outdoor clinics in most hospitals
Fine needle aspiration cytology (FNAC) of lymph node has become the initial workup in diagnosis and management of patients with lymphadenopathy due to early availability of results, simplicity and minimal trauma with less complication [4]
The diagnosis of metastatic tumor to the lymph node on cytological smear is crucial and highly reliable. This would be the sole indication for searching the primary tumor, especially in cases of occult carcinoma [7]
Summary
Cervical lymphadenopathy is commonest clinical presentations of patients, attending the outdoor clinics in most hospitals. Fine needle aspiration cytology (FNAC) of lymph node has become the initial workup in diagnosis and management of patients with lymphadenopathy due to early availability of results, simplicity and minimal trauma with less complication [4]. FNAC has been advocated as a useful method in comparison to more expensive surgical excision biopsies in developing countries with limited financial and health care resources [5] It almost offers an accurate diagnosis for infectious disease, granulomatous lymphadenitis, reactive lymphoid hyperplasia and metastatic malignancy. The diagnosis of metastatic tumor to the lymph node on cytological smear is crucial and highly reliable This would be the sole indication for searching the primary tumor, especially in cases of occult carcinoma [7]. It has the advantage that it can be done safely, rapidly and cheaply with minimal trauma at an outpatient setup or at the bedside
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