Analysis of causes of cervical lymphadenopathy using fine needle aspiration cytology and excision biopsy at tertiary hospital in India

Abstract

Introduction: The presentation of cervical lymphadenopathy is common, but its diagnosis is sometimes difficult. Fine Needle Aspiration Cytology (FNAC) is a simple, inexpensive, rapid investigative procedure to confirm clinical diagnosis with minimal trauma and low complication rate.Aim: To determine the diagnostic accuracy of FNAC and to correlate diagnosis with FNAC and subsequent histopathological examination of excised biopsy specimens.Materials and Methods: The study was done from data collected from 2013 to 2015. Total 100 Patients with cervical lymphadenopathy were clinically evaluated and FNAC, excision biopsy were done and analysed.Results: FNAC is most sensitive in diagnosing secondary deposits in neck nodes with sensitivity of 88.9%. FNAC is least sensitive in diagnosing lymphomas with sensitivity of 78.6%.FNAC is 100% specific in diagnosing Tubercular lymphadenitis, Lymphomas and secondary deposits in neck nodes. FNAC is 96% specific in diagnosing chronic nonspecific lymphadenitis and 94% specific in diagnosing Reactive changes in cervical lymph node. Overall average sensitivity and specificity of FNAC of cervical lymphadenitis is 65% and 98% respectively.Conclusion: FNAC is a very useful diagnostic tool in patients having significant lymphadenopathy. The metastatic carcinomas, especially squamous cell carcinoma and tuberculous lymphadenopathy can be diagnosed by FNAC with a high degree of accuracy. There is significant limitation in the diagnosis of low grade Non-Hodgkin’s lymphoma from reactive hyperplasia.