Fine needle aspiration cytology as a first line investigation in cervical swellings of 470 cases

Bhavna G. Gamit, Mubin I. Patel, Mandakini M. Patel, Sharmistha M. Patel


Background: Fine needle aspiration cytology (FNAC) is a first line investigation in cervical swellings. The etiology varies from an inflammatory process to a malignant condition.

Methods: The study was carried out in department of Pathology, Government Medical College, affiliated with government hospital in Gujarat. There were 470 patients with cervical swelling in a period from January 2017 to December 2017. Patients with thyroid swelling (swelling moves with deglutition) were excluded from the study. FNAC procedure was performed, smears prepared, stained with haematoxylin and eosin (H and E), May Grunwald Giemsa (MGG) and Pap stain. Zeihl Neelsen stain was carried out when required. Patient history, local examination findings and microscopic findings were recorded.

Results: Total 470 patients, age ranged from 2 months to 90 years were studied. There were 286 males and 184 females. There were 449 cases in which conclusive opinion given. 111 cases were neoplastic and 338 cases were non-neoplastic. Various cytological diagnosis were; 207 cases of granulomatous lymphadenitis (tuberculosis), 1 case of filarial lymphadenitis, 72 cases of chronic reactive hyperplasia, 25 cases of acute suppurative inflammation, 1 case of sialadenitis, 10 cases of keratinous cyst, 6 cases of benign cystic lesion, 12 cases of lipoma, 4 cases of lymphoproliferative lesion, 1 cases of benign appendage tumor, 2 cases of mucoepidermoid carcinoma, 103 cases of metastasis and 5 cases of non Hodgkin lymphoma.

Conclusions: FNAC is a simple, quick, inexpensive and minimally invasive technique to diagnose cervical swellings. It can differentiate the infective process from neoplastic one and avoids unnecessary surgeries.


Cervical swelling, FNAC, Lymphoma, Metastasis, TB

Full Text:



Nayak S, Mani R, Anita N, Kavatker, Puranik SC, Holka VV. Fine needle aspiration cytology in lymphadenopathy of HIV positive patients. Diag Cytopatho. 2003;29(3):146-8.

Orell SR, Sterrett GF, Walters NI, Whitaker D. Manual and Atlas of FNAC, 2nd ed. New York: Churchill Livingstone;1995:250.

Hirachand S, Lakhey M, Akhter J, Thapa B. Evaluation of fine needle aspiration cytology of lymph nodes in Kathmandu Medical College, Teaching hospital. Kathmandu Univ Med J. 2009;7(26):139-42.

Afridi S, Malik K, Wahed I. Role of fine needle aspiration biopsy and cytology in breast lumps. J Coll Phy Surg Pak. 1995; 5:75-7.

Howlett DC, Harper B, Quante M, Berresford A, Morley M, Grant J, et al. Diagnostic adequacy and accuracy of fine needle aspiration cytology in neck lump assessment: results from a regional cancer network over a one year period. J Laryngolog Otol. 2007 Jun;121(6):571-9.

Kollur SM, El Hag IB. Fine needle aspiration cytology of metastatic nasopharyngeal carcinoma in cervical lymph nodes: comparison with metastatic squamous cell carcinoma and Hodgkin’ and Non Hodgkin’ lymphoma. Diag Cytopathol. 2003;28:18-22.

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.

Wilkinson AR, Mahore SD, Maimoon SA. FNAC in the diagnosis of lymph node malignancies: A simple and sensitive tool. Indian journal of medical and paediatric oncology: official J Ind Soci Med Paedia Oncol. 2012 Jan;33(1):21.

Russell RCG, William NS, Bulstrode CJK. Bailey and Love’s short practice of surgery. 24th ed. London: Arnold;2004:950.

Haque MA, Talukder SI. Evaluation of fine needle aspiration cytology of lymph node in Mymensingh. Mymensingh Med J. 2003;12(1):33-5.

Schmalbach CE, Miller FR. Occult primary head and neck carcinoma. Current Oncology Reports. 2007;9(2):139-46.