Utility of fine needle aspiration cytology in metastatic lymph nodes

Abstract

Background: Fine needle aspiration cytology is a reliable as well as an inexpensive diagnostic method. It is suitable for the developing countries like Nepal for the diagnosis of lymphadenopathy at any approachable site. Fine needle aspiration cytology not only confirms the presence of metastatic disease but also, in most cases, gives the clue regarding the origin of the primary tumor. The aim of the study was to find out the cytological diagnosis of metastatic lymph node lesions. Materials and Methods:A combined prospective and retrospective study was done of all metastatic lymph node lesions (including both superficial and deep nodes) reported in Department of Pathology, Manipal Teaching Hospital, Pokhara from January 2005 to Deceember 2010. Results:A total of 4180 cases of fine needle aspiration cytology were carried out of which 508 cases were of lymph node. Cytology results were unsatisfactory in 58 specimens (12%), "reactive" or "infective" in 347 specimens (68%), positive for metastasis in 93 specimens (18%) and hematolymphoid malignancies include 10 cases (2%). The most common site was anterior and posterior triangles cervical nodes. The most common malignancy was adenocarcinoma, seen in 62 cases (67%), followed by metastatic squamous cells carcinoma (14 cases, 15%). Conclusion:Fine needle aspiration cytology of lymphadenoathy is a useful tool in diagnosing metastatic lesions with good certainty.

Metastatic Lymphadenopathy in Kashmir Valley: A Clinicopathological Study

“…Supraclavicular lymph nodes were found to be involved in majority (50.5%) of our cases followed by cervical (19.9%) and axillary lymph nodes (15%). However, in other studies, cervical lymph nodes were the most common site of involvement (Alam et al, 2010;Ghartimagar et al, 2011;Wilkinson et al, 2012). The size of the malignant lymph nodes was >1.5 cm in most (85%) of our patients which is similar to that observed by another study (Wilkinson et al, 2012).…”

“…The youngest patient in our study was a 3 years old child and the oldest one was of 90 years. Similar, wide age range was also observed in other studies (Bagwan et al, 2007;Ghartimagar et al, 2011;Wilkinson etal., 2012). Males outnumbered the females in our study with a male to female ratio of 1.3:1, which correlated well with other studies (Steel et al, 1995;Alam et al, 2010).…”

“…Males outnumbered the females in our study with a male to female ratio of 1.3:1, which correlated well with other studies (Steel et al, 1995;Alam et al, 2010). In contrast, another study (Ghartimagar et al, 2011) reported the incidence of metastasis to be more common in females than males with a male to female ratio of 1:1.25. Supraclavicular lymph nodes were found to be involved in majority (50.5%) of our cases followed by cervical (19.9%) and axillary lymph nodes (15%).…”

“…FNAC not only confirms the presence of metastatic disease but also gives clues regarding the nature and origin of primary tumor (Bagwan et al, 2007;Ghartimagar et al, 2011). The diagnosis given on the cytological material is often the only diagnosis accepted and sometimes there is no further correlation with histopathology especially in cases of advanced malignancies.…”

“…In developing countries, infective lymphadenopathy is quite common, mostly due to high prevalence of tuberculosis. However, still a large percentage of lymphadenopathies in adults turn out to be malignant (Ghartimagar et at., 2011). It is, therefore, necessary to evaluate a patient with lymphadenopathy of >3 weeks duration without any delay.…”