Image-guided fine-needle aspiration cytology of deep-seated enlarged lymph nodes.
OBJECTIVE
To evaluate the role of image-guided fine-needle aspiration cytology (FNAC) of deep-seated lymph nodes.


METHODS
Image-guided FNACs were performed on 242 patients of deep-seated lymph nodes which included thoracic, retroperitoneal and abdominal nodes. A sterile 3.5/5-MHz micro convex sector probe was used for localisation of the node. The FNAC was performed using a 0.7- to 0.9-mm needle with the stylet removed and attached to a 20-ml syringe and FNAC handle after the needle was visualised in the lesion. For each case a minimum of 4-5 smears were made, and two observers without bias interpreted the smears.


RESULTS
A total of 242 patients were aspirated, of which 216 (90%) aspirations were US-guided and the remaining 26 (10%) were CT-guided. Adequate material for cytologic diagnosis was obtained in 208 (86%) patients with a similar diagnostic accuracy. The aspirate material was non-representative or scanty in 34 (14%) patients. The most common cytological diagnosis was tuberculosis/consistent with tuberculosis seen in 108 (45%) patients followed by metastasis (17%) and reactive hyperplasia (10%). Non-Hodgkin lymphoma was diagnosed in 22 (9%) patients. All patients were briefly followed for a period of 1 1/2 to 2 years (mean 1 year).


CONCLUSIONS
Image-guided FNAC has a pivotal role, and is a cost-effective tool for establishing tissue diagnosis as a primary investigative modality. It is also helpful and accurate in follow-up of patients with a known malignant disease, thereby avoiding surgical intervention.
Nahar Saikia
U
U
Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Khirdwadkar
N
N
Saikia
B
B
Sood
B
B
Goldsmith
R
R
Dey
P
P
Gupta
S K
SK
D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography