Analysis of FNAC in diagnosis of lymphadenopathy-a retrospective study from a regional cancer centre, Cuttack, Odisha

Authors

  • Pramod Chandra Pathy Department of Head and Neck Oncology, A. H. Regional Cancer Centre, Cuttack, Odisha, India
  • Subhransu Kumar Hota Department of Pathology, A. H. Regional Cancer Centre, Cuttack, Odisha, India
  • Sashibhusan Dash Department of Pathology, A. H. Regional Cancer Centre, Cuttack, Odisha, India
  • Sagarika Samantaray Department of Pathology, A. H. Regional Cancer Centre, Cuttack, Odisha, India
  • Sasmita Panda Department of Pathology, A. H. Regional Cancer Centre, Cuttack, Odisha, India
  • Niranjan Rout Department of Pathology, A. H. Regional Cancer Centre, Cuttack, Odisha, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20175442

Keywords:

Cervical lymph node, Fine needle aspiration cytology, Lymphadenopathy, metastatic squamous cell carcinoma

Abstract

Background: Lymphadenopathy is one of the most common clinical presentations and major causes of morbidity. Thus, clinical recognition and urgent diagnosis is of paramount importance. So, we aimed to analysis the diagnostic role of fine needle aspiration cytology (FNAC) in superficial lymphadenopathy in a regional cancer centre, Odisha, India.

Methods: A total 1129 cases were retrieved from the hospital record retrospectively from the patients who had presented with superficial lymphadenopathy from January 2015 to December 2015.

Results: Out of 1129 lymphadenopathy cases, 671 (59.43%) were male and 458 (40.56%) were female with male to female ratio 1.46:1. The age of the patients ranged from 4 years to 83 years with mean age 48.57 years. The most common site was observed in cervical lymph node 493 (43.66%) followed by submandibuar lymph nodes 198 (17.53%) and supraclavicular lymph nodes 172 (15.23%). 584 (51.27%) were malignant and 545 (48.27%) were benign. Reactive hyperplasia was most common 318 (58.34%) among benign cases where as metastatic squamous cell carcinoma was the most common 261 (50.77%) among malignant lesions. By FNAC all benign lesions were correctly diagnosed, and primary sites of malignancy identified in 442 (85.59%) cases. Cyto-histo correlation was done in 399 cases. The overall diagnostic accuracy of FNAC was found to be   93.98%, sensitivity 93.88%, specificity 94.64%, positive predictive value 99.8% and negative predictive value 71.62%.

Conclusions: FNAC is a highly sensitive and specific tool for early detecting primary malignancy and metastatic lesions. Many inflammatory lesions can be treated based on FNAC alone.

References

Chawla N, Nandini NM. FNAC in lymph node disorders a hospital study in Southern India. J Cytol. 2007;24(2):105-7.

Qadri SK, Hamdani NH, Shah P, Lone MI, Baba KM. Profile of lymphadenopathy in Kashmir valley: a cytological study. Asia Pacific J Cancer Prevention. 2012;13(8):3621-5.

Wilkinson AR, Mahore SD, Maimoon SA. FNAC in the diagnosis of lymph node malignancies: A simple and sensitive tool. Ind J Medic Paedia oncol: official J Ind Society Medic Paedia Oncol. 2012;33(1):21.

Hafez NH, Tahoun NS. Reliability of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of cervical lymphadenopathy. J Egy Nation Cancer Inst. 2011;23(3):105-14.

Malhotra AS, Lahori M,Nigam A, Khajuria A. Profile of lymphadenopathy: An institutional based cytomorphological study. Int J App Basic Med Res. 2017;7:100-3.

Dhingra V, Misra V, Mishra R, Bhatia R, Singhal M. Fine needle aspiration cytology (FNAC) as a diagnostic tool in paediatric lymphadenopathy. J Clin Diagn Res. 2010;4:2452‑7.

Nidhi P, Sapna T, Shalini M, Kumud G. FNAC in tuberculous lymphadenitis: Experience from a tertiary level referral centre. Ind J Tuber. 2011;58:1027.

Steel BL, Schwartz MR, Ibrahim R. Fine needle aspiration biopsy in the diagnosis of lymphadenopathy in 1,103 patients. Acta Cytol. 1995;39:76-81.

Ahmad SS, Akhtar S, Akhtar K, Naseen S, Mansoor T. Study of fine needle aspiration cytology in lymphadenopathy with special reference to acid fast staining in cases of tuberculosis. J K Sci. 2005;7(1):1-4.

Mitra S, Ray S, Mitra PK. Fine needle aspiration cytology of supraclavicular lymph nodes: Our experience over a three-year period. J Cytol. 2011;28(3):108-10.

Gupta RK, Naran S, Lallu S, Fauck R. The diagnostic value of fine needle aspiration cytology (FNAC) in the assessment of palpable supraclavicular lymph nodes: a study of 218 cases. Cytopathology. 2003;14(4):201-7.

El Hag IA, Chiedozi LC, Al Reyees FA, Kollur SM. Fine needle aspiration cytology of head and neck masses. Acta cytologica. 2003;47(3):387-92.

Fatima S, Arshad S, Ahmed Z, Hasan SH. Spectrum of cytological findings in patients with neck lymphadenopathy-experience in a tertiary care hospital in Pakistan. Asian Pac J Cancer Prev. 2011;12(7):1873-5.

Agarwal D, Bansal P, Rani B, Sharma S, Chawla S, Bharat V, Sharma S. Evaluation of etiology of lymphadenopathy in different age groups using fine needle aspiration cytology: A retrospective study. The Internet J Pathol. 2010;10(2).

Silas OA, Ige OO, Adoga AA, Nimkur LT, Ajetunmobi OI. Role of Fine Needle Aspiration Cytology (FNAC) as a Diagnostic Tool in Paediatric Head and Neck Lymphodenopathy. J Otol Rhinol. 2015;4(1).

Prasad S, Mohan N. Efficacy of aspiration cytology in suspected metastatic neck lymph nodes. Int J Med Sci Public Heal. 2014;3:46-48.

Bhattacharjee A, Chakraborty A, Purkaystha P. Prevalence of head and neck cancers in the north east-an institutional study. Ind J Otolaryngol Head Neck Surg. 2006;58(1):15-9.

Üstün M, Risberg B, Davidson B, Berner A. Cystic change in metastatic lymph nodes: A common diagnostic pitfall in fine‐needle aspiration cytology. Diagnostic cytopathology. 2002;27(6):387-92.

Ghartimagar D, Ghosh A, Ranabhat S, Shrestha MK, Narasimhan R, Talwar OP. Utility of fine needle aspiration cytology in metastatic lymph nodes. J Pathol Nepal. 2011;1(2):92-5.

Ojo BA, Buhari MO, Malami SA, Abdulrahaman MB. Surgical lymph node biopsies in University of Ilorin Teaching Hospital, Ilorin, Nigeria. Nigerian Post Medic J. 2005;12(4):299-304.

Betsill, William L, Hajdu. Percutaneous aspiration biopsy in lymph nodes. Am J Clin Pathol. 1980;73:471-479.

Bagwan IN, Kane SV, Chinoy RF. Cytologic evaluation of the enlarged neck node: FNAC utility in metastatic neck disease. Int J Pathol. 2007;6(2).

Alam K, Khan A, Siddiqui F, Jain A, Haider N, Maheshwari V. Fine needle aspiration cytology (FNAC), a handy tool for metastatic lymphadenopathy. Int J Pathol. 2010;10(2).

Facundo DJ, Quinonez G, Ravinsky E. Transmission Electron Microscopy of Fine Needle Aspiration Biopsies of Metastases. Acta cytologica. 2003;47(3):457-62.

Downloads

Published

2017-11-25

How to Cite

Pathy, P. C., Hota, S. K., Dash, S., Samantaray, S., Panda, S., & Rout, N. (2017). Analysis of FNAC in diagnosis of lymphadenopathy-a retrospective study from a regional cancer centre, Cuttack, Odisha. International Journal of Research in Medical Sciences, 5(12), 5287–5292. https://doi.org/10.18203/2320-6012.ijrms20175442

Issue

Section

Original Research Articles