Efficacy of fine needle aspiration cytology as a primary diagnostic tool for cervical lymphadenopathy

Sarder M. Abu Horaira

doi:10.18203/2320-6012.ijrms20212221

Authors

Sarder M. Abu Horaira Department of Pathology, Rajshahi Medical College and Hospital, Rajpara, Ghoramara, Rajshahi, Bangladesh

DOI:

https://doi.org/10.18203/2320-6012.ijrms20212221

Keywords:

Fine needle aspiration cytology, Cervical lymphadenopathy, Reactive lymphadenitis

Abstract

Background: Cervical lymphadenopathy is a frequently encountered neck lesion in routine daily practice all over the globe. The etiology varies from a benign inflammatory process to a malignant condition. Fine needle aspiration cytology (FNAC) is now a days the initial investigation in most of the cases of cervical lymph node enlargement. The aim of this work was to evaluate the efficacy and diagnostic accuracy of fine needle aspiration cytology of cervical lymph nodes with an emphasis on discordant cases between the cytology and the histopathology.

Methods: The present study was a retrospective one, conducted at the department of pathology, Rajshahi medical college and hospital located in west-northern region of Bangladesh over a period of one year (January 2019 to December 2019). FNAC assessed and histopathologically correlated 122 documented cases were included in the study.

Results: The cytological diagnoses were detected to be benign in 107 cases (87.70%) and malignant in 15 cases (12.30%). Reactive lymphadenitis (67.20%) was the most common benign lesion followed by granulomatous lymphadenitis (16.40%). The overall diagnostic sensitivity, specificity, positive predictive value and negative predictive value of cytological diagnosis of cervical lymph node were 97.16%, 75%, 96.26% and 80%, respectively. The overall diagnostic accuracy was 94.26% while the overall discordance rate was 5.73%.

Conclusions: FNAC is the preliminary investigation of choice in the diagnostic approach to most of the cases of cervical lymphadenopathy and it has good diagnostic sensitivity, specificity and accuracy.

Metrics

Metrics Loading ...

References

Nancy P, Ruth C, Katz L. Lymph nodes. In: Koss LG, Melamed MR, eds. Koss Diagnostic Cytology and its histopathologic bases. 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2006: 1186-7.

Mukul P, Borsaikia K, Das BK, Hazarika A. A clinicopathological evaluation of cervical lymphadenopathy in children (0-14 years) by fine needle aspiration cytology and histopathological examination: a hospital based study. Nat J Otorhinolaryngol Head Neck Surg. 2014;2(11):12-4.

Pandit AA, Candes FP, Khubchandani SR. Fine needle aspiration cytology of lymph nodes. J Postgrad Med. 1987;33(3):134-6.

Pavithra P, Geetha JP. Role of fine needle aspiration cytology in the evaluation of the spectrum of lymph node lesions. Int J Pharm Bio Sci. 2014;5:377-84.

Keith VE, Harsharan SK, Jerald GZ. Fine needle aspiration biopsy of lymph nodes in the modern era: reactive lymphadenopathies. Pathol Case Rev. 2007;12(1):27-35.

Das DK. Value and limitation of fine-needle aspiration cytology in diagnosis and classification of lymphomas: a review. Diagn Cytopathol. 1999;21(4):240-9.

Howlett DC, Harper B, Quante M, Berresford A, Morley M, Grant J. 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 Laryngol Otol. 2007;121(6):571-9.

Khajuria R, Goswami KC, Singh K, Dubey VK. Pattern of lymphadenopathy on fine needle aspiration cytology in Jammu. JK Sci. 2006;8(3):157-9.

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. Diagn Cytopathol. 2003;28(1):18-22.

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

Upadhyay GP, Thakker RM. Evaluation of fine needle aspiration cytology as the initial diagnostic test in cases of cervical lymphadenopathy. Int J Res Med Sci. 2016;4(12):5103-7.

Badge SA, Ovhal AG, Azad K, Meshram AT. Study of fine-needle aspiration cytology of lymph node in rural area of Bastar District, Chhattisgarh. Med J DY Patil Univ. 2017;10:143-8.

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.

Chandanwale S, Buch A, Verma A, Shruthi V, Kulkarni S, Satav V. Evaluation of granulomatous lymphadenitis on fine needle aspiration cytology-diagnostic dilemma. Int J Pharma Bio Sci. 2014;5:377-84.

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.

Sarda AK, Bal S, Singh MK, Kapur MM. Fine needle aspiration cytology as a preliminary diagnostic procedure for asymptomatic cervical lymphadenopathy. JAPI. 1990;38(3):46-9.

Gupta AK, Nayar M, Chandra M. Reliability and limitations of fine needle aspiration cytology of lymphadenopathies: an analysis of 1,261 cases. Acta Cytol. 1991;35:777-83.

Raghuveer CV, Pai MR, Manohar C. Role of FNAC in disorders of lymph nodes. J Cytol. 1996;13(1):45-9

Hafez NH, Tahoun NS. Reliability of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of cervical lymphadenopathy. J Egypt Nat Cancer Institut. 2011;23(2):105-14.

Saluja JG, Ajinyka MS. Comparative study of fine needle aspiration cytology, histology and bacteriology of enlarged lymph node. Bombay Hosp J. 2000;42(2):1-7.

Ahmad T, Naeem M, Ahmad S, Samad A, Nasir A. Fine needle aspiration cytology and neck swellings in the surgical outpatient. J Ayub Med Coll Abbottabad. 2008;20(3):30-2.

Paliwal N, Thakur S, Mullick S, Gupta K. FNAC in tuberculous lymphadenitis: experience from a tertiary level referral centre. Indian J Tuberc. 2011;58(3):102-07.

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.

Nidhi P, Sapna T, Shalini M, Kumud G. FNAC in tuberculous lymphadenitis: experience from a tertiary level referral centre. Indian J Tuberc. 2011;58(3):102-07.

Lockhart J, Lopez R, Nath H. Lymph node. In: Rosai J, ed. Rosai and Ackerman’s surgical Pathology. 9th ed. Missouri: Mosby; 2004: 1978-79.

Rakhshan M, Rakhshan A. The diagnostic accuracy of fine needle aspiration cytology in neck lymphoid masses. Iranian J Pathol. 2009;4(4):147-50.

Shakya G, Malla S, Shakya KN, Shrestha R. A study of fine needle aspiration cytology of cervical lymph nodes. J Nepal Health Res Counc. 2009;7(14):1-5.

Al-Mulhim AS, Al-Ghamdi AM, Al-Marzooq HM, Mohammad HA, Gharib IA. The role of fine needle aspiration cytology and imprint cytology in cervical lymphadenopathy. Saudi Med J. 2004;25:862-5.

Al-Alwan NA, Al-Hashimi AS, Salman MM, Al-Attar EA. Fine needle aspiration cytology versus histopathology in diagnosing lymph node lesions. East Mediterr Health J. 1996;2(2):320-5.