Saturday, 14 November 2015

Etiological pattern of Lymphadenopathies and Role of Fine Needle Aspiration Cytology (FNAC) in its Diagnosis

Abstract—Lymphadenopathy is one of the commonest presentation in inflammatory and neoplastic cases. Pathological diagnosis of enlarged lymph nodes is crucial in further management of patients. Fine Needle Aspiration cytology (FNAC) is quick and cost effective OPD procedure for establishing etiology of enlarged lymph nodes. This study was aimed to observed the pattern of lymphadenopathy as per FNAC and its diagnostic accuracy assuming histopathology as gold standard. This study was conducted on two hundred and thirty one consecutive enlarged lymph nodes attended for FNAC in a secondary care level Government Hospital, Gandhi Nagar, Jammu in a study period of two and a half years. Lymph nodes of these cases were aspirated and subjected to cytomorphological evaluation with Papanicolaou (PAP) and Giemsa stain. After that histopathological examination was done of excised biopsies. Then pattern of lymphadenopathy as per FNAC was observed and its diagnostic accuracy was found out assuming histopathology as gold standard. Maximum number of patients was in the age group of 21-30 years age group with male to female ratio 1.2:1. Out of 231 lymphadenopathy cases 4 remain inconclusisve whereas 200 (88.11%)cases were benign and 27 (11.89%) were malignant including 14 (6.1%) cases of metastatic tumors. Among benign cases, majority had non specific reactive lymphadenitis (42.29%) followed by tubercular lymphadenitis. And among malignant tumors, metastatic tumors (6.1%). were most common. Diagnostic accuracy of FNAC was observed as fairly good i.e. ranging from 100% to 83.3% in various type of lymphadenopathies. So it can be depicted that FNAC is very useful first line investigation in patients presenting with enlarged lymph nodes especially in secondary level health care hospitals/centers where advanced diagnostic modalities are not available. The suspicious cases can always be referred for further evaluation.

Keywords Fine Needle Aspiration cytology (FNAC), Lymphadenopathy, Metastatic tumours, Lymphadenitis, Diagnostic Accuracy

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