Title: Morphological spectrum of enlarged peripheral lymph nodes on Fine Needle Aspiration Cytology: A study of 16,985 cases from tertiary care center in Uttarakhand

Authors: Dr Mohd Bilal Ali, Dr Ankit Kaushik, Dr Ghazala Rizvi

 DOI: https://dx.doi.org/10.18535/jmscr/v8i1.94

Abstract

Introduction: Lymph nodes are vital part of immune system. Lymphadenopathies are one of the most common clinical presentations in patients of infections & malignancies. Peripheral lymphadenopathy is a common finding across all age groups; management is dependent on lymph node pathology. Fine-needle aspiration cytology (FNAC) is a clinical technique for diagnosis of masses. The present study was undertaken to determine the cytological spectrum in enlarged peripheral lymph nodes and to study the cytomorphological pattern of metastasis in lymph nodes.

Material and Methods: This retrospective study was conducted at the Department of Pathology, Government Medical College, Haldwani, India from January 2008 to December 2018. Demographic and other relevant data was taken from records. Slides were stained with PAP, Hematoxylin and eosin (H and E) and May-Grunwald Giemsa stain (MGG). FNAC was done. Cytological diagnosis and site of peripheral lymphadenopathy were noted.

Results: Among 16,985 cases, 39.22% cases were reactive, 33.52% tubercular, 24.60% metastatic lymph nodes, 2.60% hematological malignancies, and 0.087% cases as parasitic. Cervical lymph nodes were the commonest site for metastasis (69.01% cases). Metastatic squamous cell carcinoma diagnosed in 68.65% cases, poorly differentiated carcinoma in 26.24%, adenocarcinoma in 4.65%, and poorly differentiated squamous cell carcinoma in 0.46% cases.

Conclusion: FNAC is reliable procedure for diagnosis of peripheral lymphadenopathy. Cause of lymphadenopathy varies with the demographic differences. Metastatic lymphadenopathy is common in older age group. Age, sex, and type of metastatic carcinomas vary in different regions.

Keywords: fine-needle aspiration cytology, lymph node, lymphadenitis, reactive hyperplasia, tubercular lymphadenitis.

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