Fine Needle Aspiration Cytology as Primary Diagnostic Tool in Cervical Lymphadenopathy: Systematic Approach Is the Key to Stay Relevant (Case Series)
DOI:
https://doi.org/10.21276/apalm.3909Keywords:
cytology, fine needle aspiration cytology, cervical, lymph node, diagnostic, systematic approachAbstract
Introduction: Cervical lymphadenopathy is one of the commonest clinical presentations in a number of medical and surgical conditions with final diagnosis varying from a spectrum of reactive lymphadenitis to primary lymphomas. Fine Needle aspiration cytology has been considered as the quick and minimally invasive OPD technique in establishing diagnosis in such cases. With this case series displaying a vast spectrum of diseases presenting as cervical lymph node masses, we aim at discussing a systematic approach to ensure best results with FNAC as the initial primary diagnostic modality for cervical lymphadenopathy and thus ensuring optimum utilization of available resources.
Case Presentation: We present a series of six cases which reported to our hospital from Nov 2024 to Oct 2025, displaying a vast spectrum of diseases presenting as cervical lymph node masses, primarily aiming to utilize the cost-effective diagnostic modality of FNAC to achieve best results.
Conclusion: In resource constraint scenarios, a quick, easy and minimally invasive investigative technique like FNAC while following a systematic logarithmic approach proves to be diagnostic in most of the cases, hence preventing unnecessary surgical intervention.
References
1. Bhavani C, M.N, Varalakshmi K, Babu PR, Chaitanya B, Sravani P. Role of FNAC in the diagnosis of cervical lymphadenopathy, Int J med res rev 2014, 2(6), 599-603
2. Al Quot MM, Al Hamood M, AlQahtani MS, Alqahtani AY, Asiri AH, Alshahrani AA. The Diagnostic value of Fine Needle Aspiration cytology in cervical lymphadenopathy in correlation to postoperative histopathological results in a tertiary care centre in Saudi Arabia. Cureus.2023 Sept 29;15(9):e46210
3. Chong Y, Park G, Cha HJ, Kang CS, Abdul Ghafar J, Lee SS. A stepwise approach to fine needle aspiration cytology of lymph nodes. J Pathol Transl Med.2023 Jul;57(4):196-207
4. Gupta P, Gupta N, Kumar P, Bhardwaj S, Srinivasan R, Dey P, Rohilla M, Bal A, Das A, Rajwanshi A. Assessment of risk of malignancy by application of the proposed Sydney System for classification and reporting lymph node cytopathology. Cancer Cytopathol. 2021 Sep;129(9):701-718
5. Cree, Ian A. "The WHO classification of haematolymphoid tumours." Leukemia 36.7 (2022): 1701-1702.
6. Gupta P, Bhardwaj S, Wani FA, Sayeed U, Banday A. Fine needle aspiration cytology in pediatric tumours: a low cost, high accuracy diagnostic tool for resource limited settings. Am J Transl Res. 2023Nov 15;15(11):6486-6494.
7. Rajamanickam SK, Prades Morera e, Agarwal A, Senthilkumar S, Elsaid N, Zeitoun H. Ultrasound Guided Versus Freehand Fine Needle Aspiration: A comparative Study in diagnosisng non salivary, non-thyroidal head and neck masses. Cureus. 2025 Apr 23;17(4): e82830
8. Syrykh, Charlotte, et al. "Lymph node excisions provide more precise lymphoma diagnoses than core biopsies: a French Lymphopath network survey." Blood, The Journal of the American Society of Hematology 140.24 (2022): 2573-2583.
9. Can, Ahmet Selcuk, and Kamil Peker. "Comparison of palpation-versus ultrasound-guided fine-needle aspiration biopsies in the evaluation of thyroid nodules." BMC research notes 1.1 (2008): 12.
10. Tarigan, Tri Juli Edi, et al. "Diagnostic accuracy of palpation versus ultrasound-guided fine needle aspiration biopsy for diagnosis of malignancy in thyroid nodules: a systematic review and meta-analysis." BMC endocrine disorders 22.1 (2022): 181.
11. Pambuccian SE. Overview of ancillary methods in lymph node FNA diagnosis. In: Pambuccian SE, Bardales RH. Editors. Lymph Node Cytopathology. Springer: 2011
12. Zeppa P, Cozzolino I. Fine needle cytology: technical procedures and ancillary techniques. Moogr Clin Cytol. 2018;23:4-13
13. Das S, Das A, Das B. Application of the Sydney System for classification and reporting lymph node cytopathology to assess the risk of malignancy and its diagnostic accuracy. J Cytol. 2024 Oct-Dec;41(94):201-206
14. Sable M, Panda m, Acharya P, Mishra P, Purkait S, Sethy M, Ayyanar P, Adhya AK, Patra S. Assessment of risk of malignancy with application of Sydney classification for reporting of lymph node cytopathology in pediatric population: An institutional experience. Cancer Cytopathol.2025 Feb;133(2):e22936
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Copyright (c) 2026 Khushdeep Kaur Shergill, Sunita Bisht, Hari J Pillai, Vikas Kumar, Neha Rautela, Sumeet Arora, Dayal Singh Bisht

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