CYTOMORPHOLOGICAL SPECTRUM OF PERIPHERAL LYMPHADENOPATHY IN FINE NEEDLE ASPIRATION CYTOLOGY

Abstract

Introduction: Lymph nodes are an integral component of the immune system and are affected by a multitude of pathological lesions which manifest most commonly as lymphadenopathy in clinical practice. The diagnosis of the cause underlying the enlarged lymph node(s) enables the clinician to plan appropriate management for each patient. Enlarged superficial lymph nodes are easily amenable to evaluation by FNA technique. Present retrospective cross sectional study was under taken with the aims to study the different cytomorphological patterns associated with various lymphadenopathies.

Materials and Methods: Present was a retrospective, cross sectional study conducted at Department of Pathology, at a Tertiary Care Center over a period of one and half years from January 2019 to June 2020. Wet fixed smears were stained by Hematoxylin & Eosin and Papanicolaou’s stains. Air dried smears were stained by Giemsa, Ziehl-Neelsen and Auramine-rhodamine stain. Based on the cellularity, the smears were categorized as of high, moderate and low cellularity, to reach a specific final diagnosis on FNA without any correlation with the biopsy reports.

Results: In a total of 680 lymph node aspirates, maximum incidence of cases was seen in age group of 21-40 years (39.6%), 392 (57.64%) were females and 288 (42.35%) males with male to female ratio of 0.73:1. Cervical lymph node involvement was the commonest (65.29%). Right sided peripheral lymph nodes were commonly involved (52%). Non-neoplastic lesions were 91.5% and neoplastic 8.5%. Reactive lymphadenitis (41.80%) was most common, followed by tuberculous lymphadenitis (28.13%).

Conclusion: FNAC of lymph nodes is an excellent first-line investigation to determine the nature of lesion. It is a best available alternative to surgical biopsy of lymph nodes. FNAC continues to be an important diagnostic tool in the evaluation of peripheral lymphadenopathy in developing countries like INDIA.

Keywords: Lymphadenopathy, Fine Needle Aspiration Cytology, Reactive lymphadenitis, Tuberculous lymphadenitis, Flourescent Microscopy, Zeihl-Neelsen stain