Indian Journal of Pathology and Oncology


Utility of fine needle aspiration cytology (FNAC) in evaluation of cervical lymphadenopathy


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Author Details: Mamatha K., Arakeri SU

Volume : 4

Issue : 2

Online ISSN : 2394-6792

Print ISSN : 2394-6784

Article First Page : 218

Article End Page : 220


Abstract

Introduction: Lymphadenopathy is the commonest clinical presentation encountered in outpatient as well as in inpatient departments, irrespective of age.(1) It is one of the common clinical presentation in both benign and malignant diseases.(2) Differential diagnoses include reactive hyperplasia/inflammatory conditions, granulomatous disorders and malignancy. Cervical group of lymph nodes are easily accessible for FNAC. Because of the accessibility cervical group of lymph nodes are more commonly subjected for FNAC.(6) Hence cytological study of these lymphnodes is very important first line of investigation in distinguishing between reactive hyperplasia and malignancy.
Methods and Material: Patients presented with palpable cervical lymphadenopathy referred for cytological evaluation were included. Thorough examination of the patients was done and also detailed clinical history was taken. Standard FNAC procedure was performed; multiple smears were prepared and analyzed.
Results: Total number of cases was 220. Out of which, 162 cases were benign/ infectious and 58 were malignant. Most of the cases were in the age group of 20-39years (32.7%)Reactive lymphadenitis was the commonest diagnosis on cytology constituting to 41.4% followed by malignant cases (26.3 %), granulomatous lymphadenitis (17.7%), suppurative lymphadenitis (10%) and necrotizing lymphadenitis (3.6%). Out of total 58 malignant cases, 51 (87.9%) cases were metastatic lesions, 4 cases were lymphoma and in 3 cases differential diagnosis of lymphoma/ metastatic poorly differentiated carcinoma was considered. Squamous cell carcinoma (67.2%) was the most common morphological type diagnosed on cytology in metastatic lymph nodes, followed by adenocarcinoma.
Conclusion: FNAC is a cost effective, quick and reliable, simple tool in diagnosing patients presenting with cervical lymphadenopathy. FNAC serves as a rapid tool for the diagnosis of common and treatable causes of cervical lymphadenopathy. It is also a good sensitive first line method in patients with suspected malignant cervical lymphadenopathy.

Keywords:
FNAC, Lymphadenopathy, Cervical, Biopsy, Malignancy