Vol. 5, Issue 6, Part A (2019)

Introduction: Fine Needle Aspiration Cytology (FNAC) is simple, cheap, useful and minimally invasive diagnostic tool for enlarged lymph node lesions. The present study has been undertaken to emphasize the Clinico-cytomorphological spectrum and to determine the diagnostic efficacy of FNAC in enlarged lymph nodes.

Material and Methods: A 5 year hospital based cross-sectional observational study of 1053 patients was conducted, with all relevant clinical details and FNAC was performed and dry and wet smears were prepared and stained. Ziehl-Neelsen (ZN) Staining was done wherever required. The cytomorphological features were correlated with the concomitant histopathological findings, wherever available.

Results: A total of 1053 cases were studied, with slight female preponderance of 51.6%. Out of 1053 cases, 972 were non neoplastic cases while 81 were neoplastic. Cervical group of lymph. Nodes was most commonly involved (628/1053 cases). Maximum number of aspirates were reported as Chronic non-specific lymphadenitis 32.9% (346/1053 of total). Among the neoplastic lesions (81/1053), majority of cases were of metastatic squamous cell carcinoma 42/81 (51.85%). In non-neoplastic lesions, chronic non-specific lymphadenitis and reactive lymphadenitis was most frequently seen in first decade of life, 114/346 cases and 59/182 cases respectively. Whereas tubercular lymphadenitis were more common in 21-30 years age group (101/265 cases) followed by 11-20 age group (80/265cases). Among the neoplastic cases, Metastatic squamous cell carcinoma was most commonly seen in 5th decade. Hodgkin’s lymphoma was more common in 11-20 years age group (4/11cases), whereas Non-Hodgkin’s lymphoma was maximum in 41-50 years age group (5/15cases).Out of 1053 aspirates, histopathological confirmation was available in 20 lymph node lesions. FNAC findings were correlated with histopathological diagnosis in 85% (17/20) cases. The sensitivity, specificity, positive predictive value and negative predictive value of FNAC of lymph nodes were 77.78%, 100%, 100% and 84.62% respectively. The diagnostic accuracy was 90%.

Conclusion: FNAC is an efficient minimally invasive diagnostic method for early diagnosis of enlarged lymph nodes.