A study on significance of Fine needle aspiration cytology (FNAC) of Supraclavicular lymph node in different neoplastic and non-neoplastic lesions- a retrospective observational study in a tertiary care hospital of eastern India.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 6
Abstract
Objectives: Cervical lymphadenopathy is a common clinical findings in all age groups which ranges from inflammatory, reactive conditions to metastatic lesion in etiologies. Fine needle aspiration cytology is a standard first line of investigation in the evaluation of lymphadenopathy. The majority of studies by fine needle aspiration either by directly from palpable lesions or image guided from supraclavicular lymph node reveals a malignant etiology.However, the present study further emphasizes the role of fine needle aspiration cytology for the aetiological evaluation of enlarged supraclavicular lymph node as a first line of investigation. Method: This was a retrospective observational study. All patients of palpable supraclavicular lymph node enlargement of more than 2 weeks duration and of size more than 1cm was included in this study. Fine needle aspiration was done in the department of Pathology of R.G.Kar medical college, Kolkata, with the help of 23G needle and the smears were stained with May-Grunwald-Giemsa and Papanicolaou stains. Z-N stain done where it was clinically indicated. Total study period was 2 years from January 2016 to December 2017. Results: A total of 187 patients were selected. The right supraclavicular lymph node was enlarged in 115 cases (61.5%), while in 68 cases (36.4%) it was left sided and in 4 cases (2.1%) it was both sided enlargement. Cytological diagnosis were categorized as metastasis in 83 cases (44.4%), Tuberculosis in 66 cases(35.3%), Reactive in 20 cases (10.7%), Acute suppurative lymphadenitis in 13 cases( 6.9%) and Lymphoproliferative disorder in 5 cases (2.7%). Among 83 cases of metastasic disease, major types of malignancy found were adenocarcinoma in 32 cases (38.5%), Squamous cell carcinoma in 28 cases (33.7%), poorly differentiated carcinoma in 10 cases (12.1%),small cell carcinoma in 9 cases (10.9%) and others in 4 cases (4.8%)(from ovarian , thyroid malignancy etc.). Among the primary sites lung was the most common primary site in 47 cases (56.6%) followed by breast, stomach,larynx etc. However in 10.8% cases no primary site was found. Conclusion: The fine needle aspiration cytology can be used as a first line investigation in the etiological evaluation of supraclavicular lymph node due to its low cost, simplicity and minimal invasiveness. A full history with radiological findings and histopathological confirmation guides to arrive at a definitive diagnosis.
Authors and Affiliations
Dr Santanu Nandy
Keywords
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