title: The role of fine-needle aspiration biopsy and flow cytometry in the evaluation of persistent neck adenopathy.
abstract: BACKGROUND
  The role of fine-needle aspiration biopsy (FNAB) and flow cytometry (FCM) in the evaluation of persistent neck adenopathy has not been completely defined.
  
  
  METHODS
  All patients who underwent FNAB of an abnormal lymph node from 1990 to 1997 were identified, and the results of FNAB and FCM were correlated with histology or clinical follow-up.
  
  
  RESULTS
  FNAB was performed on 133 patients with an abnormal lymph node in the neck. FNAB was malignant in 82 (62%), atypical in 13 (10%), benign in 27 (20%), and nondiagnostic in 11 (8%) patients. FNAB was compared with histologic results in 114 (86%) or with the results of clinical follow-up (average 17 months) in 12 patients (9%). Seven patients (5%) were lost to follow-up. Lymphoma and metastatic carcinoma were diagnosed in 25 (19%) and 76 (57%) patients, respectively. Sensitivity of FNAB and FCM was 96% and 100%, respectively, and specificity was 58% and 100%, respectively. Patients with Hodgkin's lymphoma accounted for 80% of false negative FCM results. FCM was nondiagnostic in 3 of 34 patients (9%). Definitive subclassification of lymphoma was accomplished in only 3 of 17 (18%) patients in whom FCM was performed.
  
  
  CONCLUSIONS
  FNAB is reliable in identifying metastatic disease, non-Hodgkin's lymphoma, and reactive lymphadenopathy in the neck. FNAB and FCM still have a limited role in definitive diagnosis of Hodgkin's lymphoma and classification of non-Hodgkin's lymphoma, underscoring the importance of excisional biopsy.
authors.affiliation: Department of Surgery, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio 44109-1998, USA.
authors.forename: D R
authors.initials: DR
authors.lastname: Tarantino
authors.forename: C R
authors.initials: CR
authors.lastname: McHenry
authors.forename: T
authors.initials: T
authors.lastname: Strickland
authors.forename: A
authors.initials: A
authors.lastname: Khiyami
mesh_terms: D001707:Biopsy, Needle; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005189:False Positive Reactions; D005434:Flow Cytometry; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008223:Lymphoma / Q000175:diagnosis* / Q000473:pathology; D009333:Neck; D012680:Sensitivity and Specificity