Fine needle aspiration cytology: A diagostic tool in evaluation of lymphadenopathy in paediatric age

Abstract

Introduction: Lymphadenopathy is one of the commonest clinical presentations in children and a common scenario for pediatrician. Unexplained lymphadenopathy often poses a great deal of anxiety and concern in parents. Fine needle aspiration cytology (FNAC) is a minimally invasive, cost effective and a well established technique as a high diagnostic efficacy tool. FNAC especially in benign inflammatory condition has aided in clinical practice by avoiding unnecessary excision biopsies also limiting its complications and psychological trauma to patient. The present study was conducted to evaluate FNAC as a diagnostic tool in pediatric lymphadenopathy and study spectrum of various cytomorphological patterns in paediatric age group. Materials and Methods: The present study was undertaken in the Department of Pathology, in a tertiary care hospital in Maharashtra. Reports of 312 pediatric FNAC (<16years) of various lymph nodes were studied from July 2014 to November 2017 retrospectively. Results: Maximum number of aspirates were found in 12-16 years (38.78%) i.e older age group and were of benign nature i.e. 96.80% with remaining (3.20%) malignant in nature. Anterior cervical lymph nodes predominate over other lymph nodes (41.02%) followed by posterior cervical lymph nodes (31.40%) when FNAC anatomical site subdivision was done. Maximum number of aspirates were found to be reactive lymphadenitis (61.53%) followed by tuberculous lymphadenitis (8.65 %). Conclusion: To conclude fine needle aspiration cytology has emerged as a reliable initial screening tool in all the lymphadenopathy cases in pediatric age group due to its cost-effectiveness and high diagnostic accuracy. A spectrum of different lesions can be evaluated by using FNAC. Pediatrician plays a very important role by taking initiative in referring all the pediatric patients for FNAC, in a resource limited settings like India.