The Pattern of Superficial Lymphadenopathy on Fine Needle Aspiration Cytology in Clinical Practice in Islamabad

Abstract

Background: In adults, lymph nodes are not normally palpable. A number of patients with asymptomatic lymphadenopathy never visit physicians for the condition, and thus, this important sign is often missed by the medical practitioner if it is not the presenting complaint. The incidence of lymphadenopathy is suggested to be increasing. While lymphadenopathy is benign and self-limiting in most patients, the underlying disease may range from treatable infectious etiology to malignant neoplasms. In most cases clinical examination and history guide towards the cause of lymphadenopathy. In recent years, fine needle aspiration cytology (FNAC) has become an easy clinical tool (with or without the assistance of CT, MRI, and ultrasound) for the diagnosis of the underlying cause of lymphadenopathy.Aims and objectives: To find out the cytomorphological pattern in superficial lymphadenopathy with the help of FNAC.Materials and methods: This descriptive cross-sectional study was conducted at HBS General Hospital, Islamabad from January 2017 to June 2019. Patients presenting with superficial lymphadenopathy were included in the study. FNAC was performed by the pathologist, histopathological reports were examined and analyzed using Statistical Package for the Social Sciences (SPSS) version 22 (IBM Corp., Armonk, NY).Results: Six hundred and thirty-two patients underwent FNAC. Tuberculous lymphadenitis was the most common diagnosis (56.1%) followed by reactive hyperplasia (28.29%). The sample showed metastatic malignancy 3.36% and lymphoma 2.05%. Cervical lymphadenopathy was the most common site for TB (49.36%). Metastatic cancer observed in cervical lymph nodes was 3.16% and lymphoma was 1.74%. Conclusion:FNAC is recognized as a simple and safe diagnostic technique that can diagnose cases of superficial and deep lymphadenopathy easily. The most common cause of superficial lymphadenopathy in our study was tuberculosis with cervical lymph nodes.

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“…For the diagnosis of tuberculous lymphadenopathy, Xpert MTB/RIF Ultra has 91%, 72% sensitivity and specificity, respectively [11]. For diagnosing tuberculous lymphadenopathy, FNAB is the best test because it provides a less invasive, less traumatic, and more practical alternative [17]. FNAB has a sensitivity of 85.78%, a specificity of 70.73%, and an accuracy of 80.95% when diagnosing lymphadenopathy [18].…”