Fine Needle Aspiration Cytology Of Cervical Lymphadenopathy: Is There Anything Different At South Coastal Region Of India?
Keywords:
Fine needle aspiration cytology, lymph node, histopathologyAbstract
Background: Cervical lymphadenopathy is one of the commonest clinical presentations of the patients in all age groups. FNAC is simple, inexpensive and minimally invasive procedure that can be used as an outpatient procedure for diagnosing lymphadenopathy cases.
Aims and Objective: To assess the various causes of cervical lymphadenopathy through FNAC and to see the distribution of various lesions with respect to age and gender and to correlate with histopathological findings.
Materials and Methods: The present Analytical cross-sectional study was conducted in the Department of Pathology, Mahatma Gandhi Medical College and Hospital, Pondicherry from January 2010 to July 2016.FNAC was done by standard procedure. All the slides were reviewed and diagnosis was rendered. Cytology findings were compared with histopathological diagnosis where-ever excision biopsy was done.
Results: A total of 411 patients were included in the present study. Overall, female preponderance was seen. In benign non-neoplastic lesions, peak occurrence was seen in the 3rd decade, whereas it was 7th decade in metastatic lesions. Benign lymphadenopathies were diagnosed in 75.1% of cases, majority being chronic reactive lymphadenitis(34.6%) followed by granulomatous lymphadenitis(30%). The proportion of granulomatous lymphadenitis was more in our study as compared to other studies(p<0.0001).In neoplastic lesions, majority (88%)were metastatic deposits. In metastatic lesions, higher proportion of metastatic thyroid carcinoma (13.9%) was seen which was statistically significant (p<0.0001) as compared to other studies. Unpaired t test was used to prove statistical significance. Cyto-histopathology correlation was done in 54 cases and FNAC showed sensitivity of 97%,specificity 95%and diagnostic accuracy of 96%.
Conclusion: FNAC is safe, simple, rapid, minimally invasive and inexpensive procedure to diagnosis cervical lymphadenopathy with high sensitivity, specificity and diagnostic accuracy. Higher frequency of granulomatous lesions was seen in non-neoplastic cases. In neoplastic lesions, metastatic thyroid carcinoma showed higher frequency in our study conducted at iodine sufficient south coastal region of India.Â
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DOI:Â 10.21276/APALM.1463
References
2. Bazemore AW, Smucker DR. Lymphadenopathy and malignancy. American family physician.2002 Dec;66(11):2103-110.
3. Young JA. Fine needle aspiration cytopathology. J of Pathol. 1993 Jan;169(1):109-114.
4. 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.
5. Howlett DC, Harper B, Quante M, Berresford A, Morley M, Grant J, Ramesar K, Barnes S. 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 Lary & Otol. 2007 Jun 1; 121(06):571-79.
6. Kline TS. Handbook of Fine Needle Aspiration Biopsy Cytology. 2nded. New York: Churchill Livingstone; 1988.p.492.
7. 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. DiagCytopathol 2003;28:18-22.
8. Miliauskas J. Diagnostic accuracy of FNAC of Lymph node lesions. In: Orell SR, Sterrett GF, editors. Fine needle aspiration cytology.5thed.New York: Churchill Livingstone;2012.p.85-86.
9. Al-Mulhim AS, Al-Ghamdi AM, Al-Marzooq YM, Hashish HM, Mohammad HA, Ali AM, Gharib IA. The role of fine needle aspiration cytology and imprint cytology in cervical lymphadenopathy. Saudi Med J.2004;25(7):862–5.
10. Haque MA, Talukder SI. Evaluation of fine needle aspiration cytology of lymph node in Mymensingh. Mymensingh Med J. 2003 Jan;12(1):33–35.
11. Gupta AK, Nayar M, Chandra M. Reliability and Limitations of Fine Needle aspiration cytology of lymphadenopathies. An analysis of 1,261 cases. ActaCytol 1991; 35: 777-83.
12. Ferrer R. Lymphadenopathy: differential diagnosis and evaluation. Am FamlPhysician 1998;58:1313-20.
13. Khajuria R, Goswami KC, Singh K, Dubey VK. Pattern of Lymphadenopathy on Fine Needle Aspiration Cytology in Jammu. JK Sci J of Cytology. 2006; July-Sep;8 (3) : 157- 59.
14. Steel BL, Schwartz MR, Ramzy I. Fine needle aspiration biopsy in the diagnosis of lymphadenopathy in 1103 patients. Role, limitations and analysis of diagnostic pitfalls. ActaCytol. 1995;39(1):76-81.
15. Nesreen H. Hafez, Neveen S. Tahoun. Reliability of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of cervical lymphadenopathy. J Egyptian Nat Cancer Inst 2011;23: 105-114
16. Sharma P, Rana S, Gill MK, Singh P, Satarkar RN, Kalhan S. Spectrum of lymph node lesions on cytology in rural Haryana: a retrospective analysis. International J Res Med Sci. 2015 May;3(5):1125-30.
17. Attaullah M, Shah W, Pervez SN, Khan S, Jehan S, Rahim S. cytomorphological pattern of superficial lymphadenopathy. Gomal Journal of Medical Sciences. 2014 Oct 1; 12(4):197-200.
18. Nidhi P, Sapna P, Shalini M and Kumud G. FNAC in tuberculous lymphadenitis- Experience from a tertiary level referral centre. Indian Journal of tuberculosis. 2011 jul; 58(3): 102-107.
19. Dukare SR, Jadhav DS, Gaikwad AL, Ranka SN, Kale PB, D’Costa G. Fine needle aspiration cytology of cervical lymphadenopathy - a study of 510 cases. Asian J Sci Technol. 2014 sep;5(9):537-40.
20. 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(4):377-84.
21. Kumar H, Chandanwale SS, Gore CR, Buch AC, Satav VH, Pagaro PM. Role of fine needle aspiration cytology in assessment of cervical lymphadenopathy. Med J DY PatilUniv 2013;6:400-4.
22. Tanteo M, Garcia R.Clinical profile and histopathologic diagnoses of childhood peripheral lymphadenopathy: an MMC experience. Paed Infect Dis Soc. Phillipines. 2011;12(2):67-74.
23. Singh N, Singh A, Chauhan R, Singh P, Verma N. Fine needle aspiration cytol¬ogy in evaluation of lymphadenopathy in pediatric age group: our experience at tertiary care centre. International Journal of Contem¬porary Medical Research. 2016;3(5):1347-51.
24. Sibanda EN, StanczukG. Lymph node pathology in Zimbabwe: a review of 2194 specimens. Quart J Med.1993;86:811-17.
25. Rathod KM, Shah SA. A Study of Metastatic Lesion of Lymph Node by Fine Needle Aspiration Cytology. Nat J Community Med.2012; 3(4):708-10.
26. Ghartimagar D, Ghosh A, Ranabhat S, Shrestha MK, Narasimhan R, Talwar OP., Utility of fine needle aspiration cytology in metastatic lymph nodes. Journal of Pathology of Nepal. 2011; 1:92-5.
27. Levi F, Vecchia CL, Randriamiharisoa A. Cancer mortality in Switzerland 1989. SozPreventimed. 1991; 36:112-126.
28. Sepuri M, Das B. Spectrum of Thyroid carcinoma in coastal Andhra Pradesh. Aretrospectivestudy. J. Evid Based Med.Healthcare.2016; 3(71): 3840-44.
29. Bharathidhasan I, Goneppanavar M, Dhaka RS. Changing trends in the incidence of thyroid lesions in coastal regions of south india. Int j Health Sci Res. 2015; 5(6):134-141.
30. Wilkinson AR, Mahore SD, Maimoon SA. FNAC in the diagnosis of lymph node malignancies: A simple and sensitive tool. Indian J Med PaediatrOncol 2012; 33:21-24.
31. Cardillo MR. Fine needle aspiration cytology of superficial lymph nodes. Diagnostic cytopathology. 1989;5(2):166-73.
32. Babu GS, Ramesh G, Kashyap B, Suneela S, Hiremath SS, Murgud S. Cytohistopathological evaluation of the cervical lymph nodes by fine needle aspiration cytology. Journal of Cranio-Maxillary Diseases.2014 ;3(2):101-5.
33. Paliwal U K,Nigam S K. Diagnostic accuracy of fine needle aspiration cytology in Cervical Lymph Nodes with Histopathological correlation. Journal of Evolution of Medical and Dental Sciences. 2013; (32): 5936-42.
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