Fine needle aspiration of lymph nodes.

Buley, I

doi:10.1136/jcp.51.12.881

Cited by 18 publications

(9 citation statements)

References 17 publications

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“…An excised lymph node provides sufficient histologic material to assess cytologic and architectural details. In many centers including ours, it is now becoming more common to forego excisional biopsy and instead perform fine-needle aspiration (FNA) as the initial work-up for lymphadenopathy [2-5]. In addition to being a safe and rapid procedure, FNAs are effective because current lymphoma classification systems place more emphasis on immunophenotype and genotype [6].…”

Section: Introductionmentioning

confidence: 99%

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Hernández¹,

Oweity²,

Ibrahim³

2005

Cytojournal

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BackgroundAn elevated CD4/CD8 T-cell ratio on flow cytometry (FCM) analysis has been reported in the literature to be associated with Hodgkin lymphoma (HL). The purpose of our study was to determine the diagnostic significance of an elevated CD4/CD8 ratio in lymph node fine needle aspiration (FNA) specimens.DesignBetween 1996 and 2002, out of 837 lymph node FNAs submitted for flow cytometry analysis, 85 cases showed an elevated CD4/CD8 ratio, defined as greater than or equal to 4, without definitive evidence of a lymphoproliferative disorder. The cytologic diagnoses of these 85 cases were grouped into four categories: reactive, atypical, Hodgkin lymphoma (HL), and non-Hodgkin lymphoma (NHL). Histologic follow-up was available in 17/85 (20%) of the cases.Results5 of the 64 cases in which FCM and cytology did not reveal evidence of a lymphoproliferative disease had tissue follow-up because of persistent lymphadenopathy and high clinical suspicion. 3/5 (60%) confirmed the diagnosis of reactive lymphadenopathy. The two remaining cases (40%) were positive for lymphoma (1HL, 1NHL). 8/15 cases called atypical on cytology had histologic follow-up. 7/8 (87.5%) cases were positive for lymphoma (3HL, 4NHL). 3/4 cases called HL on cytology had tissue follow-up and all 3 (100%) confirmed the diagnosis of HL. One case diagnosed as NHL on cytology was found to be a diffuse large B-cell lymphoma. In summary, out of 17 cases with histologic follow-up 4/17 (24%) were reactive with CD4/CD8 T-cell ratio of 4.1–29, 7/17 (41%) were HLs with CD4/CD8 T-cell ratio of 5.3 – 11, and 6/17 (35%) were NHLs with CD4/CD8 T-cell ratio of 4.2 – 14.ConclusionAn elevated CD4/CD8 ratio on FCM is a nonspecific finding which may be seen in both reactive and lymphoproliferative disorders. The cytomorphologic features of the smear are more relevant than the sole flow cytometric finding of an elevated CD4/CD8 ratio.

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Section: Introductionmentioning

confidence: 99%

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Hernández¹,

Oweity²,

Ibrahim³

2005

Cytojournal

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“…FNA is a valuable tool for the primary diagnosis of lymph nodes containing metastatic or hematologic malignancy and for staging or monitoring of relapse in patients with known malignancy. 1 The goal of this study was to compare the utility of FNA in assessing lymphadenopathy in patients with and without a history of malignancy.…”

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confidence: 99%

Fine‐needle aspiration of superficial and deeply seated lymph nodes on patients with and without a history of malignancy: Review of 439 cases

Schafernak

Kluskens

Ariga

et al. 2003

Diagnostic Cytopathology

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This study addresses the utility of fine-needle aspiration (FNA) in assessing lymphadenopathy in patients with and without a previous history of malignancy. We reviewed the FNAs of superficial and deeply seated lymph nodes performed at our institution over a period of 18 yr (1983-2001). Where applicable, we also reviewed and report here the results of subsequent surgical excisional biopsies. We analyzed data from 439 patients, who ranged in age from 1 to 90 yr. The neck and retroperitoneum were the most frequently sampled sites (47% and 25%, respectively). Among the 439 FNAs, adequate material was obtained in 421 cases (96%); the remaining 18 were unsatisfactory (4.1%). Malignant diagnoses were rendered in 330 cases (75% of 439), four were suspicious for lymphoma (0.9%), and 87 were read as reactive lymph nodes or granulomas (20%). The most common malignant cytologic diagnoses from these lymph node FNAs were adenocarcinoma, squamous cell carcinoma, and lymphoma. We compared results between two major groups: patients with a history of malignancy and those without. FNA showed malignancy in 87% of patients with a history of cancer and 41% without such a history. Thirty-three or 10% of patients with a history of malignancy were given a benign diagnosis and follow-up surgical excisional biopsies were performed in nine of these cases. Four of the nine showed low-grade lymphoma. Of the 18 non-diagnostic FNAs, nine came from patients with a history of malignancy and in six of these nine who had a follow-up surgical excisional biopsy the lymph nodes were positive for malignancy. Of the other nine, who had no history of malignancy, only two had follow-up biopsies and both of these were negative. Patients with a history of malignancy are more than twice as likely to show malignancy on lymph node FNA compared to those without such a history (87% vs. 41%). Knowing whether a patient has a history of malignancy provides the appropriate level of suspicion for ordering ancillary investigations or even recommending excisional biopsy for further evaluation.

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“…FNAC has been a suitable investigation to rule out malignancies and to confirm reactive or infective pathology. 2,3 The use of fine needle aspiration cytology (FNAC) in the investigation of lymphadenopathy has become an acceptable and widely practiced minimally invasive technique, which is safe, relatively painless, simple and rapid. FNAC is highly cost effective and accurate as a first line investigative technique.…”

Section: Introductionmentioning

confidence: 99%

Correlation of fine needle aspiration cytology lymph node with histopathological diagnosis

Gupta

Singh

2016

Int J Res Med Sci

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INTRODUCTIONFine Needle Aspiration technique was described for the first time by Greig and Gray in 1904. Since the mid-1960's, it has been increasingly used and a high degree of accuracy has been achieved.l Lymphadenopathy is one of the commonest presenting symptoms of all age groups attending out door. The etiology can vary from simple inflammatory reactive lesion to a malignant condition.Therefore lymphadenopathy requires further evaluation. FNAC has been a suitable investigation to rule out malignancies and to confirm reactive or infective pathology.2,3 The use of fine needle aspiration cytology (FNAC) in the investigation of lymphadenopathy has become an acceptable and widely practiced minimally invasive technique, which is safe, relatively painless, simple and rapid. FNAC is highly cost effective and accurate as a first line investigative technique. With the recent advances in ultrasound and CT scan technologies, focal lesions can be aspirated using this procedures. 4 Fine needle aspiration cytology (FNAC) has emerged as an advanced diagnostic tool to differentiate reactive hyperplasia/inflammatory conditions, granulomatous disorders and lymphomas. This diagnostic modality has gained considerable importance in the management of patients with lymphadenopathy over several years. We are reporting histopathological correlation of 200 cases of lymphadenopathy with FNAC. ABSTRACTBackground: Lymphadenopathy is very common presenting symptoms. Fine needle aspiration cytology (FNAC) is used to evaluate the nature of the lesion. Etiology of lymphadenopathy in head and neck region vary from benign reactive hyperplasia to tubercular granulomatous lesion to malignancy. The aim of present study was to evaluate the sensitivity, specificity and predictive value in tuberculosis and metastatic carcinoma. Methods: A total of 80 patients out of 200 patients who underwent FNAC were evaluated by histopathological examination for correlation. Aspiration smears and histopathological slides were evaluated and results were calculated for sensitivity, specificity and predictive value. Results: Reactive lymphadenitis was seen in 40 patients followed by tubercular granulomatous lymphadenitis in 20 patients and malignant lesions in 20 patients. Histology revealed 18 patients of tubercular lymphadenitis, 43 of reactive changes, 12 of metastasis in lymph nodes and 7 of lymphomas. Correlating the findings, we could achieve 100% sensitivity and 96.7% specificity for tubercular lymphadenopathy and for metastatic it was 98.5% and 100% respectively. Conclusions: We have found FNAC a satisfactory tool in the diagnosis of tubercular and malignant lymphadenopathy. FNAC used in conjunction with clinical findings, radiological and laboratory investigations can be a cost effective method for the diagnosis of lymphadenopathy.

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Fine needle aspiration of lymph nodes.

Cited by 18 publications

References 17 publications

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Fine‐needle aspiration of superficial and deeply seated lymph nodes on patients with and without a history of malignancy: Review of 439 cases

Correlation of fine needle aspiration cytology lymph node with histopathological diagnosis

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