Diagnostic value of liquid‐based cytology with fine needle aspiration specimens for cervical lymphadenopathy

Abstract

BackgroundCervical lymphadenopathy is a symptom that is frequently seen among outpatients, and it is important to differentiate malignant lesions from reactive lymphoid hyperplasia. Fine needle aspiration (FNA) cytology has been widely used for the diagnosis of cervical lymphadenopathy. However, some limitations of the diagnostic accuracy using conventional smear (CS) cytology have been pointed out. The diagnostic value of liquid‐based cytology (LBC) with FNA specimens has not yet been fully proven.MethodsForty‐two patients with cervical lymphadenopathy who underwent FNA with CS cytology from 2007 to 2011 and 123 patients who underwent FNA with LBC utilizing LBCPREP2™ from 2011 to 2015 were studied. Diagnostic values were compared between the CS and the LBC groups.ResultsOf the total 165 patients representing the combined CS and LBC groups, 81 (49.1%) were diagnosed as benign lymph node and 84 (50.9%) were malignant diseases including 37 (22.4%) of metastatic carcinoma except for thyroid carcinoma, 30 (18.2%) of metastatic thyroid carcinoma, and 17 (10.3%) of malignant lymphoma. The overall statistical values including sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the CS were 75%, 100%, 100%, 78.9%, and 87.1%, respectively, whereas those values for LBC were 91.2%, 100%, 100%, 90.7%, and 95.3%, respectively. The sensitivity of LBC for malignant diseases tended to be higher than that of CS cytology (p = 0.081).ConclusionLBC with FNA specimens from cervical lymphadenopathy is a useful and reliable method for the diagnosis of malignant diseases, especially of metastatic carcinomas, due to its increased sensitivity compared with CS cytology. Diagn. Cytopathol. 2016;44:169–176. © 2016 Wiley Periodicals, Inc.

Correlation of cytopathology with flow cytometry and histopathology for the diagnosis of hematologic malignancies in young adults presenting with cervical lymphadenopathy

“…Causes of cervical lymphadenopathy vary based on age. Overall, benign reactive lymph node aspirates comprise a large portion of the diagnoses in patients from pediatric and adult populations . In concordance to the previous studies, the majority of cases from our series were samplings of benign reactive lymph nodes, totaling 36 of the 48 patients (75%).…”

“…Overall, benign reactive lymph node aspirates comprise a large portion of the diagnoses in patients from pediatric and adult populations. [10][11][12][13][14] In concordance to the previous studies, the majority of cases from our series were samplings of benign reactive lymph nodes, totaling 36 of the 48 patients (75%). Nineteen patients had only cytologic assessment without further workup due to minimal clinical concern and did not develop subsequent hematologic malignancies.…”

Management of cytologic material, preanalytic procedures and biobanking in lymph node cytopathology

“…In reactive processes with follicular expansion, the differential diagnosis is generally with a follicular lymphoma (FL). The latter will often depend on the quantification of cell phenotypes mainly performed by FC, ICC on cytospins or LBC . There are few large series in the literature on the use of CB in reactive processes, compared to the lymphoma diagnosis, claiming high sensitivity and specificity for LN‐FNC of lymphoma diagnosis .…”

“…and formalin . The most frequently used ancillary techniques are FC, ICC, FISH and molecular tests . As far as cell storage is concerned, whereas genetic material can be obtained by any technical devise, cryostorage is the best procedure to store LN‐FNC cells, as well as other cells and tissues .…”

Fine needle aspiration cytology of cervical lymph nodes: Comparison of liquid based cytology (SurePath) and conventional preparation

“…However, LBC remains a diagnostic challenge because of a somewhat altered morphology and the presence of artifacts resulting from the chemical influences of the fixation medium and the physical forces of the processing techniques. [5][6][7] Cervical lymphadenopathy (CLN) is a symptom that is frequently seen among outpatients, and it is important to differentiate malignant lesions from reactive lymphoid hyperplasia. Fine needle aspiration cytology (FNAC) has been widely used for the diagnosis of cervical lymphadenopathy.…”