Role of Fine Needle Aspiration Cytology (FNAC) as a Diagnostic Tool in Paediatric Head and Neck Lymphodenopathy

Abstract

A neck mass that is present for longer than a week might be pathological requiring rapid and thorough evaluation. This study aims to evaluate the positive role Fine needle aspiration cytology plays in the diagnosis of pediatric patients with lymphadenopathy in the head and neck region. Fine needle aspiration of lymph nodes was carried out, fixed and stained by cytopathologists for 56 patients at the Jos University Teaching Hospital, 43 (76.8%) were inflammatory and 13 (23.2%) malignant. Reactive hyperplasia (72.1%), acute suppurative (18.6%) and tuberculosis (9.3%) constituted the inflammatory lesions. Non Hodgkins lymphoma was the commonest malignant lesion (76.9%) followed by Hodgkins lymphoma (15.4%), the least being Rhabdomyosarcoma (7.7%). Age range 10-14 years had the highest number of cases (46.4%). Males were 36 (64.3%) while females were 20 (35.7%). All malignant cases diagnosed by FNAC had to undergo confirmation/characterization by histology and had 100% concordance. Thus there were no false positives and specificity was 100%, sensitivity 100%. Of the 43 diagnosed as inflammatory by FNAC, 12 cases which did not resolve after treatment or where patients condition worsened had to undergo surgical biopsy. Out of these only 1 (8.3%) case of fungal infection was misdiagnosed by FNAC. The lymph nodes were generalized 4 (7.1%) and localized in 52 (92.9%). Maximum number of cases 53 (94.6%) had Cervical Lymphadenopathy followed by axillary 2 (3.6%) and inguinal 1 (1.8%). Out of the cervical group of nodes, the upper anterior and upper posterior deep cervical nodes were involved in majority of cases (95%).

Role of fine needle aspiration cytology in the management of supraclavicular lymph node metastasis: Review of our experience

“…15 Hematologic malignancies are far more frequent in pediatric patients than in adults. 18 In our study mean patient age for metastatic SLN was 64.5 years, and hematologic malignancies were also seen in aged patients. Breast cancer occurred in younger patients (mean: 52.2).…”

“…Patient age should also always be considered. [18][19][20] Metastatic cases are most often seen over the age of 45-50 years 12,21 and lymph nodes from pediatric patients usually show reactive lymphadenitis. 15 Hematologic malignancies are far more frequent in pediatric patients than in adults.…”

Role of FNAC in Chronic Childhood Lymphadenopathy with Suspected Tuberculosis

“…6,7 Similar to the study by Paliwal etal, Cyto diagnosis of granulomatous lymphadenitis was more (56.8%) in our study whereas reactive hyperplasia was the common findings in some studies. 8,9,10 Similar to the study by sunali gupta, our study also showed sex predilection of female predominance for granulomatous adenitis (63.1%) and reactive adenitis (62.5%) for male children. 11 No malignancies were observed in our study whereas some studies showed malignant diagnosis in childhood lymphadenopathy.…”

Histological Surprises in Benign Cytologies after Lymph Node Biopsy—Surgeon’s Knife Improving Patient Care

“…One fourth of reactive hyperplasia in FNAC was actually lymphomas on lymph node biopsy. There were no false positive cases of malignancy on FNAC [21] but there was discordance in one case where lymphoproliferative picture on FNAC turned out to be metastatic neuroendocrine cancer on histopathology. Our study reported a low sensitivity for FNAC with discordance rate of 20.3% between FNAC and biopsy.…”