Study on the Biopsy of Lymph Nodes with Inconclusive/NonSpecific Fancy Results
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 1
Abstract
Introduction : Fine needle aspiration cytology (FNAC) is a safe, quick, minimally invasive, economic and effective diagnostic technique in lymphadenopathy cases. The sensitivity and specificity of FNAC was around more than 95%. Although open biopsy followed by cytological examination still remains the standard practice for diagnosing lymph node neoplasia, yet FNAC does constitute one of the most common diagnostic technique for metastatic lymphadenopathy. Objectives: The aim of this study is to evaluate the reliability and diagnostic accuracy of fine needle aspiration cytology (FNAC) of enlarged lymph nodes with an emphasis on discordant cases between the cytology and the histopathology and to prove that it is a primary method of diagnosis in case of lymph node disease. Materials & Methods: Prospective study on 102 patients with lymphadenopathy admitted at Kasturba medical college hospitals Mangalore. Patients were subjected to FNAC and histopathology following adequate clinical examination. We estimated the correlation of histology reports of inconclusive or nonspecific FNAC results. Results: Out of 102 patients with inconclusive FNAC report 25(24.5%) had a definitive diagnosis after biopsy. Out of total 102 patients 87(85.3%) had benign and 15(14.7%) were suffering from malignant lymphadenopathy. The commonest site of the involved cervical lymphadenopathy was the upper deep cervical lymph nodes constituting 48 cases (47.1%) followed by involvement of the supraclavicular lymph nodes in 7 cases (6.9%). Conclusion: FNAC is a rapid, safe, easy and cost effective diagnostic technique which can be used for initial diagnosis of lymphadenopathy. FNAC is a very effective investigation with high accuracy rate to differentiate benign conditions from malignant ones and avoids unwanted operations. But caution is mandatory in cases of inconclusive or negative cytology report. If there is a strong clinical suspicion, negative FNAC report is to be disregarded and excision biopsy should be carried out. Analysis shows that HPE is gold standard for evaluation of lymph node enlargement in metastatic lymphadenopathy and also to confirm secondaries where primary tumor is evident and to assess the response to treatment.
Authors and Affiliations
Dr. Nidhin Mathew1, Dr. Sunil Kumar Shetty2, Dr. Yogesh Kumar3
Keywords
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- EP ID EP365933
- DOI 10.9790/0853-1703018288
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