BACKGROUNDKikuchi-Fujimoto disease has become a common cause of lymphadenopathy in many parts of the world. The cause and pathogenesis still remains a mystery. Systemic morphological studies of the disease are few from India. Aims of this study were-1. To delineate the clinical and lab features as well as lymph node morphology of Kikuchi-Fujimoto disease and to compare the above features with previous studies. 2. To compare the proliferative subtype of the disease with high-grade lymphoma and devise a scoring system that aids in differential diagnosis. MATERIALS AND METHODS35 consecutive patients diagnosed to have Kikuchi-Fujimoto Disease on lymph node biopsy in Calicut Medical College during the period January 2006 to December 2007 were evaluated for their clinical details. Their lymph node biopsies were reassessed; 15 lymph node biopsies reported as high-grade non-Hodgkin lymphoma were compared with proliferative subtype of Kikuchi Fujimoto Disease. RESULTSThe mean age in the study was 25.4 years with female: male ratio of 2.5. Cervical nodes were involved in almost all the cases. Significant number of cases were associated with leukopaenia. Of the 35 cases 17 were proliferative type (48.6%), 16 were necrotising type (45.7%) and 2 were xanthomatous type (5.7%). A scoring system was devised for discriminating between KFD and high-grade lymphoma noting certain microscopic features.

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BACKGROUNDLymphadenopathy especially in the supraclavicular region is often associated with an underlying pathology. Fine needle aspiration cytology of lymph nodes is a cost effective and simple procedure that can be carried out in the outpatient department itself which helps in deciding the management. ) was retrieved from records of the pathology department and reviewed. Relevant history, clinical examination findings and investigations were documented. Aspiration was done routinely using 23 gauge needle and smears wet fixed in isopropyl alcohol and Papanicolaou staining was done. Cases in which aspirate was inadequate were excluded from the study. The cases were broadly divided into following groups, viz., reactive lymphoid hyperplasia, acute suppurative lymphadenitis, granulomatous lymphadenitis, metastatic malignancy, lymphoma and miscellaneous cases. RESULTSA total number of 724 cases were included in the study, males constituted 66% and females 34%. Metastatic malignancy constituting 65% was the commonest cause of lymph node enlargement, followed by reactive hyperplasia 22%. Granulomatous lymphadenitis was diagnosed in 64 cases (8.8%). Rest of the causes like lymphoma, suppurative and non-specific causes constituted only a minor category. Most common site of lymphadenopathy was left side, constituting 59.4%. Metastatic malignancy was the commonest cause of supraclavicular enlargement in the age group of 40-80 yrs. On analyzing histopathology adenocarcinoma was the most common type in this study constituting 55% followed by squamous cell carcinoma in 27%. Approximately 11% were metastasis from small cell carcinoma and 5% from poorly differentiated carcinoma. In metastatic adenocarcinoma, the most common primary site was lung, constituting 54.2%. CONCLUSIONSupraclavicular lymphadenopathy is most often associated with an underlying pathology and it has to be evaluated especially in the elderly. FNAC is a cheap and reliable diagnostic tool in the initial evaluation as well as follow up of patients attending outpatient department and provides valuable information that helps in treating patients. HOW TO CITE THIS ARTICLE:Radhakrishnan D, Nair RG, Sathi PP, et al. Fine needle aspiration cytology of supraclavicular lymph node-three year retrospective study.