Clinico-Cytological and Histopathological Correlation of Lymphadenopathy in Pediatric Patients

Abstract

Objective: The aim of the present study was to evaluate the cytomorphological and histopathological (wherever possible) patterns of lymph node (LN) lesions along with clinical correlation in the pediatric population. Methods: This was a prospective study conducted on 100 pediatric patients (aged <12 years) who presented with lymphadenopathy (LAP). Fine-needle aspiration cytology (FNAC) was performed on all cases out of which only 22 underwent surgical excision and histopathological examination. Aspirated material was stained with May-Grunwald Giemsa, Papanicolaou, Z-N stain (wherever required) and for histopathology, Hematoxylin and eosin stain was used. Results: Majority number of patients was in the age group of 5–8 years (44%). Cervical LN s were most commonly involved (71%). Out of the total 100 cases, 91% were benign, 3% were malignant and 6% were inadequate. Most common cytologically diagnosed entity was non-specific reactive lymphadenitis (68%). There was one case of reactive lymphadenitis on cytology that proved to be Hodgkin lymphoma on histopathology. Two cases of generalized LAP given as atypical lymphoproliferative lesion on cytopathology proved to be acute lymphoblastic leukemia/lymphoma on further investigation. The cytomorphological findings were found to be concordant with histopathology in 21 cases out of 22 with a diagnostic accuracy rate of 95.45%. Conclusion: FNAC is especially helpful as LN biopsy is a difficult and invasive procedure in children. Although excision biopsy is the gold standard, FNAC is preferred as first-line investigation. Along with cell block analysis and ancillary techniques, it provides an excellent diagnostic accuracy.