Diagnostic accuracy of fine‐needle aspiration cytology for lymphoma: A systematic review and meta‐analysis

Abstract

Background Fine‐needle aspiration cytology (FNAC) has become one of the most useful modalities for diagnosis and staging of lymphoma. However, diagnostic accuracy of this technique has been reported with varying results across several studies around the world. Hence, this meta‐analysis was done to assess the accuracy of FNAC for lymphoma diagnosis. Methods We conducted a systematic search for all studies reporting the diagnostic accuracy of FNAC for lymphoma in the databases of PubMed Central, MEDLINE, EMBASE, MEDLINE, SCOPUS and Cochrane library from inception till January 2021. Meta‐analysis was performed using STATA software “midas” package. Results Forty‐seven studies with 7268 patients were included. The pooled sensitivity and specificity of FNAC for diagnosing lymphoma were 93% (95% CI, 90%‐95%) and 97% (95% CI, 95%‐98%), respectively. Likelihood ratio positive was 33.5 (95% CI, 18.5‐60.7) and likelihood ratio negative was 0.07 (0.05‐0.11) making the technique to occupy the left upper quadrant in LR scattergram indicating that FNAC can be used for confirmation and exclusion. There was significant heterogeneity with significant chi‐square test and I2 statistic >75%. There was significant publication bias as per Deek's test and funnel plot. Conclusion To summarize, our study found that FNAC has a vital role as a diagnostic tool for lymphoma with higher sensitivity and specificity. Further studies assessing the accuracy of FNAC on specific types of lymphoma is required.

Digital Examination of LYmph node CYtopathology Using the Sydney system (DELYCYUS): An international, multi‐institutional study

“…Ultimately, consensus should be reached on which diagnostic entities can be routinely diagnosed by LN‐FNAC and under what conditions. The integration of LN‐FNAC into clinical practice guidelines would finally allow clinicians to treat patients based on the results of LN‐FNAC when it is prudent to do so 2,4 . This will free LN‐FNAC of the burden of being considered a screening procedure to be confirmed by other tests, giving it the role of a diagnostic procedure, which it has earned through decades of experience.…”

“…Lymph node fine‐needle aspiration cytology (LN‐FNAC) is an inexpensive, effective, and safe technique for the assessment of lymphadenopathy 1–4 . However, LN‐FNAC has not yet been widely accepted, and its adoption is still controversial 5,6 .…”

“…Lymph node fine-needle aspiration cytology (LN-FNAC) is an inexpensive, effective, and safe technique for the assessment of lymphadenopathy. [1][2][3][4] However, LN-FNAC has not yet been widely accepted, and its adoption is still controversial. 5,6 Recently, a proposal for the performance, classification, and reporting of LN-FNAC was published: the Sydney system.…”