Fine Needle Aspiration Cytology (FNAC) Is the Excellent Diagnostic Modalities for Non-Hodgkin's Lymphoma (NHL) in Tertiary Care Hospital at Muzaffarpur, Bihar

Abstract

Objective: Fine needle aspiration cytology (FNAC) is popular among clinicians worldwide, as a first line of investigation in all patients with lymphadenopathy and is preferred over biopsy because of its minimally invasive nature and cost effectiveness. Aim of present study was to diagnosing and grading of NHLs on morphological parameters by FNAC. The cytological grading accuracy is compared with the histological grades assigned according to the International Working Formulation (IWF) system which relies solely on morphological features, most important of which is cell size. Materials and Methods: A total of 76 patients present with lymphadenopathy were sending to our department for FNAC from different OPD and IPD were included in the study. These were cases where a cytological diagnosis of NHL or suspicious of NHL was made and corresponding histological sections available and cases where a diagnosis of NHL was made in histology and corresponding FNAC smears were available irrespective of the cytological diagnosis. Cases were also graded on FNAC smears using a three tier grading system based upon cell size into low, intermediate and high grades. Cytological assigned grades were correlated with the corresponding histological grades (IWF) to determine grading accuracy. Result: Out of 76 patients an accurate diagnosis of NHL was possible in 54 (71.05%) patients. Overall accurate grading was seen in 52 (68.42%) patients using cytological criteria. Out of which Accurate cytological grading was possible in 31 patients (59.61%) as low grade, 15 patients (28.84%) as intermediate and 6 patients (11.54%) as high grade Non-Hodgkin's lymphomas. Conclusion:The diagnostic accuracy of FNAC for NHLs was determined using histology as the gold standard. This study highlights the utility of FNAC as a morphological tool for diagnosing and grading NHLs in a significant number of cases. This modality may assist clinicians in management of cases of NHLs, especially in centers working within the constraints of limited availability or non availability of ancillary techniques.