Ultrasound-Guided Aspiration Cytology of Enlarged Lymph Nodes

Abstract

Cytological results of US-guided fine needle aspiration biopsies of enlarged lymph nodes from 179patients were analyzed retrospectively. The final diagnoses were benign lymphadenopathy in 90 cases, metastasis in 56, and malignant lymphoma in 33 cases. The material was sufficient for cytological analysis in 174 cases (97.2%). Correct diagnosis of malignant (C IV-V) and benign (C I-II) lymphadenopathy in the whole material was possible in 80 percent of cases. Correct subtyping of lymphoma was possible in 63.6 percent of the cases. There was one (0.6%) false positive (C IV), 6 (8.5%) false negative (C I-II), and 24 (13.8%) suspicious (C III) cytological findings. All but one of the false negative cytological findings were from superficial lymph nodes. No complications occurred. USguided lymph node aspiration biopsy is safe and accurate in the superficial, anterior mediastinal, abdominal, and retroperitoneal lymphonodal areas. Lymph nodes with a C 0 cytological result should undergo rebiopsy and suspicious (C III) or clinically doubtful cases should be referred for a surgical biopsy.

Sonographically guided fine needle aspiration biopsy of abdominal lymph nodes: experience in 102 patients.

“…Our success rate of 85.2% in obtaining tissue adequate for cytologic or histologic diagnosis is comparable to the rates reported in several other studies of sonographic and CT guided abdominal lymph node biopsies. 3,8,10,11,14,15 Although efficacy and accuracy of FNAB in the diagnosis of metastatic lymphadenopathy from epithelial carcinomas of the gastrointestinal and genitourinary tracts 2,5,7-10,16 and also tuberculous lymphadenopathy 5 are well recognized and documented, cytologic study of lymphomas has generally been regarded as difficult, especially for subtyping. 3,17 However, a number of recent studies have shown that lymph node biopsy is useful and accurate in the diagnosis of lymphoma and its recurrence.…”

“…3,8,10,11,14,15 Although efficacy and accuracy of FNAB in the diagnosis of metastatic lymphadenopathy from epithelial carcinomas of the gastrointestinal and genitourinary tracts 2,5,7-10,16 and also tuberculous lymphadenopathy 5 are well recognized and documented, cytologic study of lymphomas has generally been regarded as difficult, especially for subtyping. 3,17 However, a number of recent studies have shown that lymph node biopsy is useful and accurate in the diagnosis of lymphoma and its recurrence. 3,18,19 Negative results on FNAB do not always exclude the existence of a pathologic process and should be followed by a repeat procedure with large bore needle or an open biopsy 3,18,19 ; four of our patients with negative FNAB results were finally diagnosed as having malignant lymphomas on excisional nodal biopsy.…”

“…3,17 However, a number of recent studies have shown that lymph node biopsy is useful and accurate in the diagnosis of lymphoma and its recurrence. 3,18,19 Negative results on FNAB do not always exclude the existence of a pathologic process and should be followed by a repeat procedure with large bore needle or an open biopsy 3,18,19 ; four of our patients with negative FNAB results were finally diagnosed as having malignant lymphomas on excisional nodal biopsy.…”

Needle track seeding in renal mass biopsies

“…Needle track seeding by tumor cells in renal mass biopsy is a complication that has been reported 4 times in the past (prior to 1992) when larger (up to 14‐gauge) needles often were used, but had become vanishingly rare. However, a total of 12 additional cases of needle track seeding have been reported with core needle biopsy since 2013, predominantly from Europe . The incidence is not well characterized, but in 1 large meta‐analysis there was 1 case reported in nearly 3000 patients .…”

Spectrum of cytological finding in superficial lymphnode enlargement in a tertiary care center-retrospective study

“…We also encountered a single case of malignant melanoma deposits in the inguinal lymph node from a patient with primary malignant melanoma in the ipsilateral foot [11,14]. The smear studied shows scattered pleomorphic cells with few binucleate or multinucleate forms with 1-2 prominent nucleoli.…”