Study of Diagnostic Efficacy of the Fine Needle Aspiration Cytology of Lymphadenopathy as Compared to Open Biopsy for Histopathological Examination
Journal Title: Indian Journal of Pathology: Research and Practice - Year 2017, Vol 6, Issue 2
Abstract
Background: Lymphadenopathy is an abnormal increase in size and/ or altered consistency of lymph nodes. It is a very common clinical manifestation of regional or systemic disease caused by the invasion or propagation of either inflammatory cells or neoplastic cells into the node and serves as an excellent clue to the underlying disease. Objectives: The study was undertaken to evaluate the diagnostic efficacy of the fine needle aspiration cytology of lymphadenopathy as compared to open biopsy for histopathological examination, to study the frequency of various neoplastic versus non-neoplastic lesions, their distribution in different age groups and to study the different cytomorphological patterns associated with various lymphadenopathies. Methods: A prospective study was conducted in 400 patients with lymphadenopathy referred to the Departmet of pathology, S.V.S Medical college & Hospital , Mahabubnagar. FNA diagnosis was subsequently correlated and compared with the biopsy diagnosis in the available cases. Results: Out of 400 patients of FNAC for lymphadenopathy excisional biopsy was available in only 85 cases. Non neoplastic & neoplastic lesions were been in 308 cases & 64 cases respectively. 28 smears were non diagnostic. Tuberculous lymphadenitis was the most common lesion in 45.75% of the cases. The overall diagnostic accuracy of FNAC in the present study was 89.41.% with accuracy of 87.19 % for tuberculous lymphadenitis and 1000.00% for metastatic carcinoma. Cervical group of lymphnodes were the most commonly affected group of lymph nodes 59.75%. Epithelioid granulomas with necrosis was the predominant microscopic pattern seen in 55.19% cases Overall AFB positivity was seen in 31.14% cases & predominantly seen in necrosis alone pattern(79%), In our study sensitivity, specificity, Positive and negative predictive values of FNAC in lymphadenopathy were 100 %, 96.97%, 90.48% and 100 % respectively. Conclusion: FNAC is a simple,rapid,cost effective diagnostic tool for patients having significant lymphadenopathy. The metastatic carcinomas, and tuberculous lymphadenopathy can be diagnosed by FNAC with a high degree of accuracy. If FNAC is positive surgeon can proceed to treat the patient without excisional biopsy of the enlarged lymph nodes & most of the diseases are medically curable with limited role for surgery in non-neoplastic lesions. Lack of tissue architecture on FNAC can be overcome by subjecting samples to flow cytometry, T-cell, B-cell markers and immunocytochemistry analysis.
Authors and Affiliations
Sravani P.
Keywords
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- EP ID EP464340
- DOI 10.21088/ijprp.2278.148X.62(pt-II)17.24
- Views 94
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