Abstract
Objectives: The present study was undertaken to establish the etiologic diagnosis of enlarged lymph nodes and to classify the spectrum of diseases causing lymphadenopathy by Fine needle aspiration cytology.
Methods: The study was carried out over a period of 4 years. Fine needle aspiration cytology was performed in 893 patients presenting with lymphadenopathy. Patients included in the present study were in the age group of 9 months to 80 years.
Results: There were 482 males and 411 females. Maximum number of cases were in the age range of 21-40 years. The most common site of enlarged lymph nodes was cervical group of lymph nodes. Tuberculous lymphadenitis was seen as most common inflammatory disease followed by reactive and acute lymphadenitis. In neoplastic diseases, metastatic tumors in head and neck region were most common followed by lymphomas. 65 patients were HIV positive. In these patients, enlarged lymph nodes were mostly secondary to tuberculosis. Histopathology and cytology correlation was available in only 30 cases. One case of non-specific lymphadenitis was over-diagnosed as non-hodgkin lymphoma on cytology. The accuracy rate was 100% in tuberculous lymphadenitis, non-hodgkin lymphoma and metastatic squamous cell carcinomas.
Conclusions: Thus Fine needle aspiration cytology of lymph nodes as a first line of investigation is a cost-effective procedure and is not only useful in the diagnosis of various lesions but can also help in deciding on appropriate management.
Keywords: Fine needle aspiration cytology, Tuberculous lymphadenitis, Metastatic tumors, Lymphoma.
References
- Kanhere S. Evaluation of fine needle aspiration cytology in lymphadenopathy cases. Ind J Surg 1994; 56 (4) : 169 – 174.
- Singh UR, Bhatia A, Gadre DV, Talwar V. Cytologic diagnosis of tuberculous lymphadenitis in children by fine needle aspiration. Ind J Paed 1992; 59: 115 – 118.
- Steel, Schwariz MR, Ramzy I, et al. Fine Needle Aspiration Biopsy in the diagnosis of lymphadenopathy in 1,103 patient- role, limitations and analysis of diagnostic pitfalls. Acta cytol 1995; 42: 202.
- Das DK, Subhash Gupta. Fine Needle Aspiration Cytodiagnosis of Hodgkin’s disease and it’s subtypes. Acta Cytol 1990; 34(3): 329 – 340.
- Rajaskaran S, Gunsekaran M, Jayakumar DD, Jeyaganesh D, Bhanumati V. Tuberculosis cervical lymphadenitis in HIV positive and negative patients. Ind J Tub 2001; 48: 201 – 204.
- Bhargava P, Jain AK. Chronic cervical lymphadenopathy- a study of 100 cases. Ind J Surg 2002; 64(4): 344 – 346.
- Dasgupta A, Ghosh RN, Poddar AK, Mukherjee C, Mitra PK, Gupta G, et al. FNAC of cervical lymphadenopathy with special reference to tuberculosis. J of Ind Med Assoc 1993; 982(2): 44 -46.
- Gupta AK. Reliability and Limitations of Fine Needle Aspiration cytology of Lymphadenopathies- An analysis of 1,261 cases. Acta cytol 1991; 35(6): 777 – 783.
- Kline TS, Kannan V, Kline IK. Lymphadenopathy and Aspiration Biospy Cytology. Review of 376 superficial nodes. Cancer 1984; 54: 1076 – 1081.
- Khajuria R, Goswami KC, Singh K, Dubey VK. Pattern of Lymphadenopathy on Fine needle aspiration cytology in Jammu. JK Science 2006 ; 8 (3): 157-159.
- Gupta AK, Nayar M, Chandra M, et al. Critical Appraisal of Fine Needle Aspiration Cytology in tuberculous lymphadenitis. Acta Cytol 1992; 36(3): 391 – 3911.
- Hirachand S, Lakhey M, Akhter J, Thapa B. Evaluation of fine needle aspiration cytology of lymph nodes in Kathmandu Medical College, Teaching hospital. Kathmandu University Medical Journal 2009; 7(2): 139-142.
- Betsill W, Hajdu S. Percutaneous aspiration biopsy of lymphnodes. Am J Clin Pathol 1980; 73: 417 – 479.
- Ahmad SS, Akhtar S, Akhtar K, Naseem S, Mansoor T, Khalil S. Incidence of Tuberculosis from Study of Fine Needle Aspiration Cytology in lymphadenopathy and Acid Fast Staining. Ind J Comm Med 2005;30(2)
- Baily TM, Akhtar M, Ali MA. Fine needle aspiration biopsy in the diagnosis of tuberculosis. Acta cytol 1985; 29(5): 732 – 736.
- Vanisri HR, Nandini NM, Sunila R. Fine needle aspiration cytology findings in HIV lymphadenopathy. Ind J Pathol Microbiol 2008;51(4): 481-484.
- Satyanarayana S, Kalghatgi AT, Muralidhar A, Prasad RS, Jawed KZ, Trehan A. Fine needle aspiration cytology of lymph nodes in HIV infected patients. Med J Armed Forces India 2002;58:33-7.
- Shenoy R, Kapadi SN, Pai KP, Kini H, Mallya S, Khadilkar UN,et al.Fine needle aspiration diagnosis in HIV related lymphadenopathy in Mangalore, India. Acta Cytol 2002;46:35-9.
- Bottles K, McPhau LW, Volberding P, Fine needle aspiration biopsy of patients with AIDS experience in an outpatient clinic. Ann Intern Med 1988;108:42-5.
- Martin Bates E, Tanner A, Suvarna SK, et al. Use of FNA cytology for investigating lymphadenopathy in HIV positive patient. J Clin Pathol 1993; 46: 564 – 566.
- 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‑
- Badge SA, Ovhal AG, Azad K, Meshram AT. Study of Fine-needle aspiration cytology of lymph node in rural area of Bastar District, Chhattisgarh. Medical journal of Dr D.Y. Patil Vidyapeeth 2017; 10 (2): 143-148.
Corresponding Author
Dr Neha Mukesh Goel
204/5, Nai Sarak, Shastri Nagar, Meerut, U.P-250001
Mobile No: 08999371416, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i6.163
