Reaffirming the Diagnostic Role of Fine Needle Aspiration Cytology in an Analytical Study of Clinico-pathological Profile of Peripheral Lymphadenopathy

Background: Lymphadenopathy is one of the commonest manifestations of a variety of diseases of diverse etiology. Tuberculosis, metastasis, acute suppurations and lymphomas are some of the entities. Fine needle aspiration cytology is a precise diagnostic technique for evaluation of different causations of lymphadenopathy and is comparable to the gold standard test excision biopsy and histopathological examination.

Aims and Objectives: The study was designed to evaluate the clinicopathological profile of patients presenting with peripheral lymphadenopathy, establishing the role of fine needle aspiration cytology in the etiological diagnosis and to assess its sensitivity and specificity to correlate the findings with histopathological examination.

Materials and Methods: One year single centered hospital based prospective analytical study was conducted in a tertiary care teaching hospital in north eastern India among 100 adult patients aged above 15 years presenting with accessible peripheral lymphadenopathy.

Results and Observation: A male preponderance with maximum occurrence in the age group 15-40 years with features of neck swelling, fever, night sweats, unilateral cervical lymphnode involvement, anemia and raised ESR were common. Fine needle aspiration cytology was successfully done in 98% cases whereas excision biopsy in 90% cases. Diagnosis arrived on the basis of aspiration cytology and histopathology were tubercular in 52.04% vs 52.22%, metastasis in 25.51% vs 28.88%, nonspecific reactive lymphadenitis in 17.34% vs 13.33%. Hodgkin’s and Non-Hodgkin’s lymphoma in 2.04% vs 2.22% and 3.06% vs 3.33% cases respectively. The respective sensitivity and specificity of aspiration cytology vis-a-vis histopathology obtained in various groups are statistically significant (p< 0.0001) in each of tuberculosis 95.65% vs 100%, metastasis 96% vs 100%, nonspecific reactive lymphadenitis 100% vs 96%, Hodgkin’s lymphoma and Non-Hodgkin’s lymphoma 100% vs 100%.

Conclusion: Peripheral lymphadenopathy is a manifestation of a variety of diseases and fine needle aspiration cytology is a convenient and accurate diagnostic tool in evaluation of lymphadenopathies.