Vidya K, Subramanya N. K
BACKGROUND: Lymphadenopathy is one of the common clinical presentations of patients. It has a varied aetiology which varies from an inflammatory process to a malignant condition. Fine Needle Aspiration Cytology (FNAC) is an accurate, simple and an easy diagnostic technique in evaluation of the causes of lymphadenopathy, and the reports can be made available within an hour that will form the basis of treatment, reduce the number of surgical procedures and unnecessary surgical intervention. OBJECTIVES: To study the cytological features in lymphadenopathy and categorize them with respect to aetiology, age, sex and site of occurrence, and to have a histopathological correlation of FNAC findings, wherever possible. METHODS: All patients referred to the Department of Pathology of a Tertiary hospital for FNAC of superficial and deep lymph nodes in the study period were enrolled for the study. The patients were clinically evaluated and clinical details were obtained from the medical records. FNAC was performed and their diagnosis made. The data was analysed. In 41 cases, FNAC diagnosis was correlated with histopathological diagnosis. RESULTS: Out of the total 678 cases (including 22 guided cases) only 03 aspirates were inadequate for reporting. Most of the cases were in the age group of 20 - 29 years, with a male preponderance. The most commonly involved were cervical group of nodes, with the deep-seated nodes least involved.83.33% of cases were diagnosed as benign lymphadenopathies, most of which were reactive lymphadenitis (50.44%). ZN stain for AFB was positive in 24.49% of cases with suspected tuberculosis. Maximum number of positive cases (56.75%) was found, when purulent material was aspirated. Metastatic deposits were seen in 12.68% of cases. Most common subtype was poorly differentiated carcinoma.17 cases were diagnosed as Lymphomas, of which 10 were Hodgkin’s lymphoma and 7 were Non-Hodgkin’s. Histopathological data was available for 41 cases. 38 cases correlated well with FNAC. There was good correlation between FNAC and histopathology with an overall agreement of 92.7% (38 out of 41). Considering histopathology as gold standard, specificity of FNAC was 92.7%. CONCLUSION: Fine Needle Aspiration Cytology (FNAC) is an accurate diagnostic technique in diagnosing aetiology of lymphadenopathies which is one of the commonest clinical presentations of patients attending a health care centre and which can have an inflammatory to a neoplastic aetiology. FNAC provides a speedy diagnosis which will help the clinician to confirm or exclude the clinical differential diagnosis made at first visit of the patient and helps him to further plan the treatment. With the advent of ultrasound and computerized tomographic machines, the evaluation of deep-seated lymph nodes has also become possible through Guided FNAC’s.
