Role Of Fine Needle Aspiration Cytology Research Articles

The Role of Fine-needle Aspiration Cytology in Guiding Clinicians for Lymphadenopathy

Abstract Background: Lymphadenopathy is a very common, routinely observed clinical finding which may be caused by a variety of pathological conditions, either a primary lymph node pathology or an underlying systemic disease. Fine-needle aspiration is a simple cost-effective diagnostic tool to screen these lesions, to enhance our knowledge, to understand lymph node pathology, as well as to assist clinicians for an effective management. Aim: The aim of our study was to evaluate the patterns of pathological lesions on lymph node cytology and also to assess any particular trend of diseases in comparison with demographic variables, lymph node size, and consistency in this geographic area. Materials and Methods: In this retrospective study, we studied the reports of 131 lymph node cytology samples collected over a duration of 1 year. All parameters were entered in the Excel sheet and were analyzed for descriptive statistics. Results: The mean age of the patients was 32 years. Reactive lymphadenitis was the most common (42%) pathology, followed by tubercular lymphadenitis, metastatic lymph nodes, and lymphomas. Infectious or inflammatory lesions were noted in younger age groups, whereas malignancies were prominent in elderly patients. Conclusion: This study threw light on diseases, whether infectious, inflammatory, or lymphoproliferative in etiology, which presented with lymphadenopathy in this coastal area and also unveiled the patterns of metastatic lymph nodes, their primary site, and predilection for a particular nodal site.

Role of fine-needle aspiration cytology in the evaluation of salivary gland lesion with utilization of Milan system for reporting

Background: Fine-needle aspiration cytology (FNAC) plays a role in the pre-operative diagnosis of salivary gland mass lesion. Salivary gland neoplasm accounts for 6% of all head and neck tumors. It is widely used safe and relatively non-traumatic procedure that can quickly provide important information. “The Milan system for reporting salivary gland cytopathology” (MSRSGC) was introduced, providing a guide for diagnosis and management according to the risk of malignancy (ROM) in different categories. Aims and Objectives: The objectives of the study are as follows: (1) To evaluate different types of salivary gland lesion in tertiary care center. (2) To see application of Milan system in the present scenario. Materials and Methods: A hospital-based and prospective study was conducted between March 2021 and September 2022 on all cases of salivary gland lesions who were referred for FNAC to the Department of Pathology at Netaji Subhash Chandra Bose Medical College Hospital in Jabalpur, Madhya Pradesh. In the present study, we categorize salivary gland cytopathology result as per Milan system (MSRSGC) and calculated diagnostic accuracy and ROM in each category of Milan system (MSRSGC). Results: Seventy seven cases distributed according to Milan category as follows: Non-diagnostic (ND) (2.59), non-neoplastic (NN) (29.33%), atypia of undetermined significance (AUS) (1.29%), 4a. Benign (29.87%), 4b. Salivary gland neoplasm of uncertain malignant potential (SUMP) (1.29%), suspicious of malignancy (SOM) (1.29%), and malignancy (10.38%). Out of 77 cases, histological follow-up was available in 27 cases and the ROM was calculated. The ROM for each category of the Milan system is as follows: ND (0%), NN (6.66%), AUS (100%), 4a. Benign (9.09%), 4b. SUMP (0%), SOM (100%), and Malignancy (100%). The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 77.7%, 100%, 100%, 92.59%, and 94.11%. Conclusion: FNAC of the salivary gland lesions is a safe, minimum invasive, and reliable diagnostic procedure. The Milan system of reporting is a risk stratification system which can improve the overall effectiveness of reporting.

Mucormycosis: Cytomorphological Spectrum in Fine-Needle Aspiration Cytology.

Mucormycosis is a fungal infection that can affect multiple organs. The role of fine-needle aspiration cytology (FNAC) in its diagnosis is not well documented. The objective of this study was to describe the detailed cytomorphologic features of mucormycosis on FNAC samples. A retrospective analysis of all cases diagnosed as mucormycosis on FNAC between January 2014 and July 2021 was performed for detailed cytomorphological evaluation and correlation to clinical data and microbiological studies wherever available. FNA was computed tomography-guided (n = 38), ultrasonography-guided (n = 31) or palpation-guided (n = 12), and slides were reviewed in two cases. A total of 83 cases of mucormycosis were evaluated. An immunocompromised setting was observed in 48 cases. The most common site of FNA was the lung (n = 57) followed by liver, soft tissue, palate, mediastinum, orbital/ocular region, and lymph node. Isolated renal involvement, a unique feature, was seen in seven cases. The aspirates were necrotic to pus-like or blood-mixed particulate. Broad, nonseptate, foldable, ribbon-like fungal hyphae showing right-angled branching were seen. The tissue reaction was predominantly necro-inflammatory (n = 36), bland necrotic (n = 22), mixed inflammatory (n = 16), suppurative (n = 5), necrotizing granulomatous (n = 3), and granulomatous (n = 1). Immunocompromised patients showed mixed inflammatory responses more frequently. Fungal culture was positive for Rhizopus species in 2/13 cases and molecular testing in two additional cases corresponding to Rhizopus and Syncephalastrum spp. FNA provides quick and conclusive diagnosis of mucormycosis from varied anatomic sites enabling prompt institution of therapy. The tissue response is variable and to some extent dependent on the immune status of the patient.

Diagnostic role of FNA cytology in the evaluation of cervical lymph nodes in thyroid cancers: Combined evaluation of thyroglobulin in eluate from FNA cytology.

The presurgical evaluation of cervical lymph nodes (CLNs) in the management of thyroid malignant lesions is crucial for the extent of surgery or detection of metastases. In these last decades, fine-needle aspiration cytology (FNAC) has been shown to have a central role in the detection of nodal thyroid metastases. It is adopted for the possibility of confirming suspected metastases either in the presurgical phase or in the follow-up of patients after thyroidectomy. However, FNAC from CLNs can be challenging, especially in cystic lesions. In this regard, the combination of FNAC with thyroglobulin measurement in the eluate from FNAC (Tg-FNAC) seems to increase the sensitivity of FNAC in the detection of CLN metastases. The role of FNAC and Tg-FNAC was investigated in this series. One hundred fifty-three prospective cytological samples of CLNs were studied along with surgical follow-up in the period between 2020 and 2022. Immunocytochemistry (ICC) was performed on liquid-based cytology-stored material. One hundred fifty-nine enlarged CLNs included 19 central lymph nodes and 140 CLNs. Forty-two thyroidal CLN metastases and 117 reactive lymph nodes were found. Thirty-one CLN dissections were performed in patients with a previous diagnosis of thyroid carcinoma (mostly papillary thyroid carcinoma [PTC]), whereas 128 CLNs with a concomitant suspicious and/or malignant thyroid nodule were found. There was one false-positive case among all the malignant histologically confirmed cases, and two of 117 reactive CLNs (1.7%) had a diagnosis of metastatic PTC. Markedly high Tg-FNAC was found in all metastatic CLNs, including 11 cystic metastatic CLNs detected by Tg-FNAC with a negative FNAC. ICC (including Tg, CK-19, and LCA) recognized nine cases with low Tg-FNAC and scant suspicious thyrocytes. Tg-FNAC plus FNAC diagnosed 94.2% of malignancies. FNAC represents a valid method for the evaluation of CLNs, especially combined with ICC. Tg-FNAC is an additional method with a useful role in FNAC.

Role of fine-needle aspiration cytology as an inexpensive tool for diagnosis of idiopathic granulomatous mastitis

Role of fine-needle aspiration cytology as an inexpensive tool for diagnosis of idiopathic granulomatous mastitis

Cytopathological Evaluation of Paediatric Non-Thyroidal Neck Swelling–Experience in a Tertiary Care Children Hospital

Background and Objective: Fine needle aspiration cytology (FNAC) is well accepted as a useful diagnostic technique in the management of adult patients with head and neck lumps. However, until recently, few reports have been obtained regarding the role of FNAC in non-thyroidal neck masses in children. Therefore, the objective of our study was to determine the diagnostic value of fine needle aspiration cytology in the diagnosis of pediatric non-thyroidal neck masses. Methods: This descriptive study was conducted at the Department of Pathology of Bangladesh Shishu (Children) Hospital & Institute January 2019 to December 2021. Hundred patients with non-thyroidal neck masses fulfilling the inclusion criteria were included in the study. Fine needle aspirations were performed, smears prepared and stained by Hematoxylin and Eosin stain. Results: The most common non-neoplastic neck swelling seen in children were an enlarged lymph node due to inflammation 38(42.2%), i.e., reactive lymphadenitis. Others were TB lymphadenitis 25 (27.8%), non-TB granulomatous lymphadenitis 2(2.22%), chronic sialadenitis 2(2.22%), branchial cyst 4(4.44%) and epidermal cyst 3(3.33%) cases. Overall sensitivity, specificity, positive predictive value and negative predictive value of FNAC in our cases are 93.06%, 72.22%, 93.06% and 72.22%. Conclusion: FNA is an important diagnostic tool in the management of childhood neck lesion with the clinical presentation. The procedure decreases the requirement for more invasive and costly procedures like surgical biopsy.

Transthoracic Fine-Needle Aspiration Cytology of Pulmonary Spindle and Mesenchymal Neoplasms: A Pandora’s Box

Introduction: Pulmonary spindle cell and mesenchymal lesions are paradox for pathologists due to their rarity, overlapping morphology, and differentials ranging from benign to malignant lesions, and correct diagnosis is essential due to major treatment implications. This study highlights the role of fine-needle aspiration cytology, clot core biopsy, and immunohistochemistry in diagnosis of spindle cell lesions in lung, thus playing a key role in patient management. Methods: It is a retrospective study of lung FNA with predominantly spindle and mesenchymal cells from 2015–2020 which were classified cytomorphologically into spindle, epithelioid, small round cell, and biphasic, and IHC panels are applied accordingly. FNA from mediastinum and chest wall was excluded. Results: 60 cases of lung FNA with spindle and mesenchymal cells were identified and included 6 benign and 54 malignancies which included 24 primary pulmonary malignancies and 30 metastases. Most common primary malignancy was sarcomatoid carcinoma, and most common metastasis was malignant peripheral nerve sheath tumour. FNA was paucicellular in 7 cases and was reported as benign in 7 cases and malignant in 46 cases. There were two false-negative cases. One case of pulmonary blastoma was reported as inflammatory pseudotumour on cytology, and other case of chondrosarcoma was reported as chondroid tumour. Sensitivity and specificity of FNA in distinguishing benign lesions and malignancies were 93.8% and 100%, respectively. Conclusion: FNA along with clot core biopsy/cell block and IHC plays a pivotal role in the subsequent pathway taken for diagnostic or therapeutic management of these patients without the need for second sampling or trucut biopsies in a low resource setting.

A study on cervical lymphadenopathy in a rural based teaching hospital in India

Background: Presence of cervical lymphadenopathy may indicate serious systemic disease process. Proper evaluation of cervical lymphadenopathy is of extreme clinical importance. Aims and Objective: The study objective was to evaluate clinical and demographic profile of cervical lymphadenopathy, to find the etiology, and to study the role of fine-needle aspiration cytology (FNAC) in it’s etiological diagnosis. Materials and Methods: Prospective observational study was carried out in a rural based teaching hospital in India for 1 year. One hundred and twenty-one patients of more than 12 years of age from both genders were included in the study. Detailed history, clinical, blood examination, radiological, microbiological evaluation, and FNAC from lymph node were done for all patients. Excision biopsy was done for selective cases. Results: It was a male predominant study with male: female ratio of 1.12:1 and mean age of the patient was 34.54 years. Cervical lymphadenopathy was mostly unilateral (77.69%) and it was more common in the right side (43.80%). Tuberculosis (TB) (36.37%) was the most common cause of cervical lymphadenopathy in our study followed by reactive hyperplasia of lymph node (23.14%) and metastatic deposit (19%). Among metastatic deposit, 9 (39.13%) had squamous cell carcinoma, 5 (21.74%) had adenocarcinoma, and 1 (4.35%) had small cell carcinoma. Conclusion: TB is the most common cause of cervical lymphadenopathy followed by reactive hyperplasia and metastatic secondary deposit. FNAC is a simple inexpensive relatively painless rapid and reliable method for diagnosis which can be considered as a frontline investigation and can guide requirement for further investigation in the management of cervical lymphadenopathy.

Diagnosis of parathyroid incidentaloma detected on thyroid ultrasonography: the role of fine-needle aspiration cytology and washout parathyroid hormone measurements.

The aim of this study was to assess the diagnostic role of fine-needle aspiration cytology (FNAC) and analyze factors associated with false-negative FNAC results in patients with parathyroid incidentaloma who were referred for ultrasonography (US)-guided fine-needle aspiration (FNA) of thyroid nodules. In this study, 121 patients with suspected parathyroid lesions were enrolled. The patients underwent US-guided FNAC with measurements of washout parathyroid hormone (PTH) between January 2015 and May 2020. The diagnostic performance of FNAC for the diagnosis of parathyroid lesions was assessed using surgical results and elevated washout PTH as a reference standard. The clinical and radiologic features associated with false-negative results on FNAC for the diagnosis of parathyroid lesions were evaluated. Among the 121 nodules assessed, 38 were parathyroid lesions (31.4%), and 83 were non-parathyroid lesions (68.6%). The diagnostic performance of FNAC for parathyroid incidentaloma showed a sensitivity of 31.6% (12/38), specificity of 100% (83/83), positive predictive values of 100% (12/12), negative predictive values of 76.1% (83/109), and accuracy of 78.5% (95/121). The FNAC results of non-parathyroid lesions included thyroid nodules, lymph nodes, neurogenic tumors, and fat tissue. True-positive results on FNAC were significantly associated with performing FNA twice (58.3% vs. 23.1%, P=0.043). Considering the low sensitivity of FNAC, measuring washout PTH in addition to FNAC may help accurately diagnose parathyroid incidentaloma on thyroid US. Further, the falsenegative rate for FNAC can be reduced by obtaining two or more FNA samples.

Metastases to the thyroid gland: ultrasonographic findings and diagnostic value of fine-needle aspiration cytology.

IntroductionIn the present study, we aimed to analyze ultrasonographic findings of metastases to the thyroid and explore the role of fine-needle aspiration cytology (FNAC) in the diagnosis of metastases to the thyroid.MethodsTwelve cases of cytologically or/and pathologically confirmed metastatic tumors of the thyroid gland were reviewed. All the primary thyroid lesions and lymphomas were excluded. The location, maximum size, echogenicity, shape, margin, presence of calcifications, vascularity, and cervical lymph nodes were assessed on ultrasonography. In addition, the results of cytology or pathology (or both) were noted retrospectively.ResultsEight of 10 patients were diagnosed correctly with FNAC. Two cases presented with diffuse involvement in both thyroid lobes. Nine cases demonstrated a hypoechoic nodule with an irregular margin, four of which had microcalcifications. One case presented with a mixed solid and cystic mass with an oval shape. The lesions with cervical lymph nodes were found in seven cases.ConclusionMost metastatic thyroid cancer has similar ultrasound features to primary thyroid cancer. In some cases with atypical US features, ultrasound diagnosis should be combined with the medical history. FNAC might be helpful in the diagnosis.

Comparative study of fine-needle aspiration cytology and needle core biopsy in the diagnosis of breast lumps with histopathological correlation

Introduction: Diseases of breast constitute a large proportion of cases in surgical practice and need to be differentiate between benign from malignant lesions prior to definite treatment. Aims and Objective: The aim is to determine the accuracy with the benign and malignant lesions can be differentiated by fine-needle aspiration cytology (FNAC) and needle core biopsy (NCB) and to correlate the findings of NCB with histopathological diagnosis. Materials and Methods: It is a prospective study for one and half years comprising of 104 patients of breast lumps who underwent FNAC, NCB, and surgical excision followed by histopathological examination. Data have been collected and analyzed regarding sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FNAC and NCB in comparison with histopathology (HP). Results: Out of 104 patients, the most common age group is 41–50 years (35 cases, 33.7%). The most common HP diagnosis was infiltrating ductal carcinoma followed by ductal carcinoma in situ (50 cases and 12 cases, respectively). In our study, we found FNAC has sensitivity 94.3%, specificity 100%, PPV 100%, NPV 87.9%, diagnostic efficiency 95% while NCB has sensitivity 97.3%, specificity 100%, PPV 100%, NPV 81.8% and diagnostic accuracy 97.6% in diagnosing breast lumps. Conclusion: NCB is better in comparison to FNAC in diagnosing breast lumps. However, the role of FNAC cannot be ignored in our settings especially in the diagnosis of benign breast conditions. NCB should be considered as second-line method of investigation in case of any doubt to rule out missed diagnosis of breast carcinoma.

Role of Fine Needle Aspiration Cytology (FNAC) in Preoperative Diagnosis of Parotid and Submandibular Gland Neoplasm

Background: The overall incidence of salivary gland neoplasm is 2.5-3.0 per 100000 per year. Salivary gland malignancies account for about 5% of head-neck malignancies. Though, it is uncommon but not rare in our country. Fine Needle Aspiration Cytology (FNAC) has been widely used for many years as a method for assessing salivary gland lesion preoperatively. It is a simple, quick, inexpensive and minimally invasive technique used to diagnose different types of salivary gland neoplasm. Objectives: To see the frequency of malignancy in parotid and submandibular salivary gland neoplasm and also to find out the role of FNAC in their preoperative diagnosis. Histopathological examination of the resected parotid and submandibular gland neoplasm was considered as gold standard to compare FNAC report of this study. Methods: This was a cross – sectional study which was conducted in the Department of Otolaryngology – Head & Neck Surgery, Dhaka Medical College Hospital, Dhaka from January 2017 to June 2018. Purposive sampling method was used to collect data. Pre-tested structured data sheet was used to record information. After collection, data were edited by meticulous checking and re-checking. Data were analyzed using SPSS for windows version 22. Results: After histopathological confirmation of the resected specimen, most common benign parotid tumour was pleomorphic adenoma 76.7% followed by warthin’s tumour 16.7%. In benign submandibular gland neoplasm, pleomorphic adenoma was the commones 87.5% followed by haemangioma 12.5%. Commonest malignant tumour of submandibular gland was adenoid cystic carcinoma 50.0%. In our study sensitivity of FNAC was 75.0%, specificity 94.74% and overall accuracy was 90%. Positive predictive value and negative value were 81.82% and 92.31% respectively. Conclusion: It can be concluded that fine needle aspiration cytology is a safe, cheap and useful preoperative diagnostic tool in the diagnosis of malignancy in parotid and submandibular gland, but as fine needle aspiration cytology partly depends on operator skill, it may give false negative and false positive result. Bangladesh J Otorhinolaryngol 2021; 27(2): 124-129

Giant cell tumor of tendon sheath—Use of fine-needle aspiration cytology for diagnosis

<p class="Body"><span lang="EN-US">Giant cell tumour of the tendon sheath (GCTTS) is a slow-growing, usually painless benign lesion of soft tissues<span style="font-size: 8.33333px;">.</span> We report the case of a 38-year-old male with a painless, slowly enlarging swelling on right thumb in order to highlight the role of fine-needle aspiration cytology (FNAC) in diagnosing GCTTS.</span></p>

Diagnostic use of fine-needle aspiration cytology and core-needle biopsy in head and neck sarcomas.

The diagnostic role of fine-needle aspiration cytology (FNAC) and core-needle biopsy (CNB) has not been comprehensively assessed in head and neck sarcomas. A systematic review of published cases (1990-2020) was conducted. Diagnostic performance of both FNAC/CNB to determine tumor dignity and histopathological diagnosis was calculated. One hundred and sixty-eight cases were included for which FNAC (n = 156), CNB (n = 8), or both (n = 4) were used. Predominant histologies were skeletal muscle, chondrogenic and vascular sarcomas. FNAC correctly assessed dignity in 76.3% and histology in 45% of cases. Dignity was significantly better for vascular tumors, metastatic and recurrent specimens, and worse for chondrogenic sarcomas. CNB showed a 92% accuracy to identify dignity and 83% for histopathology. FNAC and CNB are useful methods for the diagnosis of head and neck sarcomas, particularly well-suited in the context of recurrent or metastatic disease. The role of CNB remains largely unexplored for this indication.

Cytological Evaluation Of Enlarged Lymphnodes In Metastatic Disease

Introduction: Lymphnodes are common site of metastases for different cancers. Thus, clinical recognition and urgent diagnosis of palpable lymphadenopathy is of paramount importance; specially to differentiate between inflammatory lesions from neoplastic lesions. Fine needle aspiration cytology (FNAC) of the lymph node is a simple diagnostic tool to diagnose suspected and unsuspected lymph node malignancy.Aims–To find out the role of FNAC in the diagnosis of metastatic lesions of lymphnode and whenever possible, for typing of tumor.Material &Method– A total 900 patients, who presented with lymphadenopathy were studied at AMC MET medical College and L.G hospital, Ahmedabad, Gujarat for a period of 2 years. FNAC of enlarged lymphnode was performed and stain with hematoxylin and eosin.Results- Out of total 900 cases studied, 785 were benign and 95 were malignant lesions. Twenty cases were inconclusive. Among the malignant lesions, 80 cases were found to be metastatic lesions. Maximum numbers of metastatic lesions were found in cervical lymphnodes and metastatic squamous cell carcinoma was the most common lesion followed by metastatic adenocarcinoma.Conclusion- FNAC is a simple, rapid, accurate and non-expensive diagnostic technique which can be used for the initial diagnosis of metastatic lymphadenopathy. It can give significant clue to detect the primary site of the tumor in cases with hidden malignancy, who are presented with metastatic lymphadenopathy as an initial sign. Therefore, FNAC is a useful tool in diagnosing metastatic lesion of lymphnodes.

Fine-Needle Aspiration Cytology of Salivary Gland Tumors Before the Milan System: Ten Years of Experience at a Tertiary Care Center in Turkey.

ObjectiveThe role of fine-needle aspiration cytology (FNAC) is well established for preoperative evaluation of patients with salivary gland lesions. However, the lack of a uniform system for salivary gland FNAC has limited its effectiveness. In recent years, the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) has been in use around the world to report the cytology results. We aimed to investigate the efficacy and accuracy of FNAC examined according to pre-MSRSGC era dichotomous benign/malignant classification in salivary gland tumors.MethodsPatients who underwent surgery between January 2011 and December 2020 due to major salivary gland tumors were retrospectively analyzed. Two hundred and four patients were included in the analysis. Preoperative FNAC results and final histopatological diagnoses were grouped as benign or malignant. Final histopatological diagnoses were compared with the preoperative FNAC results. Also, sensitivity, specificity, and accuracy of the preoperative FNAC results, as well as the agreement between both tests were investigated.ResultsThe sensitivity, specificity, accuracy, positive and negative predictive values of the preoperative FNAC for the diagnosis of malignancy were 59.09%, 97.85%, 93.75%, 76.47%, and 95.29%, respectively. There was a moderate agreement between the preoperative FNAC results and final histopatological diagnoses.ConclusionThe accuracy of the preoperative FNAC and the information given about malignancy risk are the most important criteria for patient management and decision-making. The MSRSGC, which consists of a six-tiered classification rather than a dichotomous “yes/no” system, may contribute to patient management and decision-making by increasing the efficacy and accuracy of FNAC.

English

BACKGROUND Salivary gland (SG) neoplasms are rare, constitute of 3 - 4 % of head and neck tumours. 70 - 80 % of SG neoplasms occur in parotid gland. These are unique in the way they present, generally slow growing. A study was conducted to analyse various modes of presentation of SG tumours and to review the role of FNAC (Fine Needle Aspiration Cytology) in the diagnosis of SG tumours. METHODS This was a prospective study, conducted in the department of surgical oncology, October 2016 to July 2018. Individuals aged >18 years, came with swelling of the SGs were considered. Swellings that were not neoplasms, the individuals with inflammatory or infections of SGs, autoimmune diseases were excluded. Statistical analysis were performed by SPSS software version-21 and MS excel 2013. RESULTS Out of 40 participants, male female ratio was 2.07. The age was ranged between 31 – 70 years, maximum (80 %) members were in 41 – 60 group. Parotid gland was the most commonly followed by submandibular gland (20 %). Swelling alone was observed in 82.5 % (33) cases, two cases (5 %) presented with swelling along with pain with facial nerve involvement. CONCLUSIONS SG tumours occur in 4th to 6th decade, common among men. Parotid gland is most frequently involved, most often benign. FNAC had good accuracy in diagnosis and surgery is the main modality of treatment. KEYWORDS Salivary Gland, Tumour, Neoplasms, FNAC

Diagnosis of nontuberculous mycobacterial lymphadenitis: the role of fine-needle aspiration.

Nontuberculous mycobacterial lymphadenitis often presents a diagnostic challenge. This study aimed to evaluate the role of fine-needle aspiration cytology in the diagnosis of nontuberculous mycobacterial lymphadenitis in children. We conducted a retrospective review of fine-needle aspiration cytology performed in patients < 17year-old with subacute lymphadenitis from 2003 to 2016 in a tertiary hospital in Spain. Confirmed nontuberculous mycobacterial lymphadenitis (isolation of nontuberculous mycobacterial in culture from fine-needle aspiration cytology or biopsy samples) and probable nontuberculous mycobacterial lymphadenitis ("granulomatous inflammation" in cytopathologic examinations from fine-needle aspiration cytology or biopsy and clinical-epidemiological history compatible with nontuberculous mycobacterial) were selected. Forty-one patients with nontuberculous mycobacterial lymphadenitis were included: 14 confirmed and 27 probable. Fine-needle aspiration cytology was done in all of them. For 34 patients with excised lymphadenopathy, cytopathology from fine-needle aspiration cytology was concordant with biopsy in 100% cases. Culture results were available from 78.0% (32/41) of patients with fine-needle aspiration cytology and from 85.3% (29/34) with excisional biopsy. Among 22 patients with microbiological results from fine-needle aspiration cytology and biopsy, fine-needle aspiration cytology allowed advanced results in concordance with biopsy or with positive isolation not found in biopsy in 90.1% (20/22) of patients. Sensitivity of nontuberculous mycobacterial cultures obtained by fine-needle aspiration cytology compared to biopsy was 45.5% vs. 36.4% (p = 0.07). Two patients with previous skin alterations presented fistulas after fine-needle aspiration cytology (4.9%); no other complications were described.Conclusion: Fine-needle aspiration cytology provides quick cytopathologic information and is an accurate and safe technique for the diagnosis of nontuberculous mycobacterial lymphadenitis, especially in cases with challenging work-up. What is Known: • Nontuberculous mycobacterial (NTM) infection is an important cause of subacute lymphadenitis in children. • Fine-needle aspiration cytology (FNAC) is an available technique for the diagnosis of lymphadenitis of unknown etiology. What is New: • FNAC is an accurate and safe technique for the diagnosis of NTM lymphadenitis in children. • FNAC can provide reliable samples for cytopathological studies and even a better sensitivity for microbiological culture than excisional biopsy in the study of suspected NTM lymphadenitis.

A study on evaluation of the role of fine-needle aspiration cytology in the etiology of lymphadenopathy in the rural population attending tertiary care hospital

Introduction: Lymph nodes are a site for organized collections of lymphoreticular tissue and arepink-gray bean-shaped encapsulated organs. Lymph nodes are among the commonly aspiratedorgans for diagnostic purposes. Lymphadenopathy is of great clinical significance as underlyingdiseases may range from a treatable infectious etiology to malignant neoplasms Fine needleaspiration cytology (FNAC) is a reliable as well as an inexpensive method used to diagnoselymphadenopathy of various sites. Aims: To evaluate the usefulness of FNAC as a diagnostic tool inthe etiological causes of lymphadenopathy and to study the cytomorphological features associatedwith various lymphadenopathies. Materials and Methods: The present prospective study wascarried out in the Department of Pathology at Maharajah's Institute of Medical Sciences,Vizianagaram, a Tertiary Care Centre. A total of 210 patients of all age groups underwent FNAC ofenlarged lymph nodes during this study period. Results: FNAC diagnosis was found to be as follows:tubercular lymphadenitis in 98 cases (46.67%) followed by reactive hyperplasia in 35 cases(16.67%), metastatic carcinoma 29 (13.8%), granulomatous lymphadenitis 27 (12.85%), non-specific lymphadenitis 8 (3.8%), acute suppurative lymphadenitis 7 (3.33%) and lymphoma 4 (1.8).Conclusion: FNAC of lymph nodes is an excellent first-line investigation to determine the nature ofthe lesion. It is quick, safe, minimally invasive, and reliable and is readily accepted by the patient.

Role of fine-needle aspiration cytology in evaluating thyroid nodules. A retrospective study from a tertiary care center of Western region, Saudi Arabia.

Objectives:To evaluate the accuracy and efficacy of fine-needle aspiration cytology (FNAC) in diagnosing thyroid nodules, correlating it with the histopathological findings.Methods:A retrospective evaluation of 314 patients was undertaken at a tertiary referral center of King Abdullah Medical City (KAMC), Makkah, Kingdom of Saudi Arabia, between 2010-2019. Patients who presented with thyroid swellings underwent ultrasonography and FNAC. If indicated, surgery was performed. The FNAC findings were compared to the final histopathological reports.Results:The findings for FNAC from our data set of 314 patients showed a sensitivity value of 79.8%, specificity of 82.1%, accuracy of 74.8%, positive predictive value of 74.8%, and negative predictive value of 85.9%.Conclusion:Our study showed that FNAC has high sensitivity and specificity in the initial evaluation of patients with thyroid nodules. When guided by ultrasonography, the accuracy can be markedly improved. Molecular markers once widely available can improve the diagnostic power of FNAC to be no less than the histopathologic evaluation of thyroid tissue.