Abstract
Lymphadenopathy is a common presentation in both benign and malignant diseases which need to be diagnosed without delay. Fine needle aspiration cytology (FNAC) helps us diagnose a disease and follow its course, including the response to therapy. This study aimed to analyze the clinicopathological features of metastatic lymphadenopathy and the diagnostic utility of FNAC in our setting. This two-year prospective study included all the patients with metastatic lymphadenopathy, diagnosed with FNAC. A total of 412 cases (male:female ratio, 1.3:1; age range, 3 to 90 years) were studied. Supraclavicular lymph nodes were involved most commonly (50.5%). The commonest metastatic tumor was squamous cell carcinoma in general (30.1%) and in males (37.6%), and infiltrating ductal carcinoma (25.3%) in females. Lung, with 64 (15.5%) cases followed by esophagus, 60 (14.6%) cases; breast, 49 (11.9%) cases; skin, 32 (7.8%) cases; and stomach, 25 (6.1%) cases were the most common primary sites of malignancy. In 69 patients, excision biopsy was performed. Histopathological findings correlated well with that of cytology in all these cases. FNAC is an important tool in the diagnostic work up of metastatic lymphadenopathy, which in the hands of an experienced and skilful cytopathologist can avoid the need for excision biopsy.
Highlights
Lymphadenopathy occurs in response to foreign antigens or by invasion or propagation of either inflammatory or neoplastic cells into the node, depending upon the geographical conditions and socioeconomical set up (Darnal et al, 2005; Bhuyan et al, 2008; Ahmad et al, 2009)
Fine needle aspiration cytology (FNAC) is an important tool in the diagnostic work up of metastatic lymphadenopathy, which in the hands of an experienced and skilful cytopathologist can avoid the need for excision biopsy
Out of a total of 5129 cases of FNAC performed during this 2 year study period, 1314 FNACs (25.6%) were done from lymph nodes and among them, 412 nodal FNACs (31.4%) reported as ‘metastatic’ were studied
Summary
Lymphadenopathy (abnormality in size, consistency or number of lymph nodes) occurs in response to foreign antigens or by invasion or propagation of either inflammatory or neoplastic cells into the node, depending upon the geographical conditions and socioeconomical set up (Darnal et al, 2005; Bhuyan et al, 2008; Ahmad et al, 2009). Still a large percentage of lymphadenopathies in adults turn out to be malignant (Ghartimagar et at., 2011) It is, necessary to evaluate a patient with lymphadenopathy of >3 weeks duration without any delay. The use of fine needle aspiration cytology (FNAC) for the diagnosis of metastatic malignancies in the lymph nodes is a well established method (Steel et al, 1995). Fine needle aspiration cytology (FNAC) helps us diagnose a disease and follow its course, including the response to therapy. Materials and Methods: This two-year prospective study included all the patients with metastatic lymphadenopathy, diagnosed with FNAC. Conclusions: FNAC is an important tool in the diagnostic work up of metastatic lymphadenopathy, which in the hands of an experienced and skilful cytopathologist can avoid the need for excision biopsy
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